Conventional open repair of descending thoracic aortic aneurysms

Conventional open reconstruction of the descending thoracic aorta is a safe and effective therapy for the management of aneurysms and is the standard by which all other therapies should be compared. Advances in surgical techniques, circulation management, neurocerebral protection, anesthesia, and postoperative management have contributed to significant reductions in morbidity and mortality over the past 50 years. More recently, endovascular stent grafting has begun to supplant conventional open repair based on its ease of performance and a perception of reduced morbidity and mortality. In reality, when carefully compared, differences in primary outcomes (mortality, stroke rate, and paraplegia) between open repair and endovascular repair are not so clear, and the long-term durability of endovascular repairs is not yet known. Open descending thoracic aortic repair still has an important role in the management of descending thoracic aortic disease in the current era.