Surgical treatment of thoracoabdominal aortic aneurysm with graft inclusion technique

Two male patients with huge thoracoabdominal aortic aneurysms were treated surgically at the National Taiwan University Hospital (NTUH) during the last 6 years. Case 1 was 70 years old with a case of malignant lymphoma. A huge thoracoabdominal aortic aneurysm was found which ruptured suddenly during the course of chemotherapy for malignant lymphoma. An emergency operation was performed because the patient suffered from profound shock. Case 2 was 34 years old and was referred to our hospital with a huge pulsating mass over his abdomen and progressive dysphagia. Both had atherosclerosis, thought to be the underlying etiology. The surgical technique we employed was the graft inclusion technique with major branch vessel reattachment to the side holes of the graft. Postoperative surgical results were excellent. Neither spinal cord complications nor visceral organ failure was found in either case. Case 1 unfortunately died 3 months after surgery because of advanced lymphoma with many organs being involved and upper GI bleeding. Case 2 is doing well and being followed up at our OPD at present.