[Surgical treatment of thoracic aneurysms with reference to the Carpentier technique]

Carpentier described Tromboexclusion for treating aortic dissections type B claiming lower perioperative neurologic and haemorrhagic complications. We performed this operation in 12 exceptional cases with acute (6) and chronic (2) type B dissections, 2 patients with aorto-bronchial fistulas and infected grafts, and 2 patients with both thoracic and abdominal aneurysm. All patients were in haemorrhagic shock and had wall penetration or perforation. In addition to the Carpentier operation 3 aorto-subclavian, 2 aorto-bifemoral and 1 renal bypass grafts and 1 AVR and 2 ascending aorta replacements were performed. Seven patients died perioperatively: 3 because of massive haemorrhage and 4 due to pancreatitis and renal failure. Five patients survived the operation, three of those died 6-28 months later because of recurrent dissections. One sudden death one month after operation is unknown. One patient survived long term. In our patients, this operation showed high mortality rates and is therefore rarely recommendable.