Transabdominal exposure of the thoracic aorta

The thoracic aorta can be exposed from an abdominal approach by means of an incision in the diaphragm. This method has been used extensively by Crawford and colleagues but has not been described in detail. Patients with normal renal function before the operation suffered no permanent renal damage from periods of ischemia for up to 45 minutes under normothermic conditions. One patient with impaired renal function before the operation sustained permanent renal damage.