Aneurysms involving the aortic arch. Report on thirteen surgically treated patients

Since the beginning of 1980, 13 patients with aneurysms of the aortic arch have been operated in our department. In 4 cases the aneurysm was limited to the aortic arch, while in 10 patients the ascending aorta was involved. In 7 patients an emergency procedure was required. Eleven patients were operated using deep hypothermia and circulatory arrest, in 2 right axillary and femoral artery cannulation with moderate hypothermia was used. In 5 patients a concomitant aortic insufficiency was corrected with a mechanical valve. Three patients died in the hospital. Transient cerebral dysfunctions occurred in 4 patients. Deep hypothermia and circulatory arrest provided a convenient method especially in older patients. Bleeding due to generalized coagulopathy and bleeding diathesis was one of the major problems. The methods adopted to avoid these complications are reported and discussed in detail.