Aneurysms of the descending aorta: surgical experience with three methods of adjunct procedures

Thirteen patients were surgically treated for the repair of aneurysms of the descending aorta, using three different types of adjunct procedures--an external temporary bypass with a vascular prosthesis, a tridodecylmethylammonium chloride (TDMAC) or a partial cardiopulmonary bypass. There was no operative death, though one patient died 73 days following surgery. Significant intraoperative morbidity occurred in 3 patients: one had ventricular fibrillation and the other two massive hemorrhages. There was no instance of paraplegia or renal failure. The only significant complication that developed was pulmonary insufficiency in two patients with a pump bypass. The mean operative time and the mean aortic occlusion time in patients with the TDMAC shunt were shorter than the times in patients with the vascular prosthetic shunt or the pump bypass. TDMAC shunt required no special equipment and cannulation was simpler and safer.