Rupture of non-traumatic thoracic aneurysms into the right hemithorax

The natural progression of arteriosclerotic descending thoracic aneurysms results in rupture in a high percentage of patients. Reports of surgical experience with these problems are not common although much as been written about elective resection of thoracic aneurysms. Two patients with ruptured non-traumatic descending thoracic aneurysms are presented. hemorrhage into the right hemithorax was a presenting manifestation in both patients. The mechanism for this type of rupture is discussed. Both patients were operated upon with one survivor. Preoperative evaluation, operative approach, and methods of bypass are discussed.