[Acute and chronic aortic rupture. Management without and with a protective bypass procedure]

The use of partial cardiopulmonary bypass in the surgery of thoracic aortic ruptures is still a matter of controversey. Since 1970, 38 patients with thoracic aortic rupture have been treated at our institution, 13 in a acute or subacute stage and 25 with traumatic aneurysm. Partial cardiopulmonary bypass was installed in 13 cases, and in 23 patients the "clamp and repair" technique was performed. Although there was no coherence between the occurrence of complications and the applied procedure, we prefer the use of partial cardiopulmonary bypass in view of the advantages in safe distal perfusion, direct retransfusion of blood, controlled decompression of the left heart, and the possibility to extend surgery to the aortic arch.