Surgery for aneurysms involving the thoraco-abdominal aorta. Report on 2 patients

The surgical management of 2 patients presenting with symptomatic thoraco-abdominal aneurysms is reported. In the first patient a technique which utilized multiple side-arm grafts to the visceral arteries is described. In the second patient we used the simpler and more expeditious technique of anastomosing the visceral artery orifices to "windows" in the aortic replacement graft from within the opened aneurysm. The merits and demerits of the different techniques and their hazards are discussed. It would seem that few aneurysms can be regarded as inoperable.