[The strategy and procedure in the surgical treatment of thoracic aortic aneurysms]

This is a summed up report on experience had with patients operated for aneurysms of the thoracic aorta since 1994. Between March 1994 and March 1994, a total of 192 patients undergo surgical treatment for aneurysms of the thoracic aorta (mean age 51.2 years). Of them 152 are men (79.1 per cent). Of the total number 109 cases have acute dissecting aneurysms, and 31--chronic aneurysms. In 114 cases the aneurysms is limited to the ascending aorta only, and in 22-in the descending aorta. The transverse aortic arch is involved in 56 patients. The prevailing preoperative clinical symptoms include: chest pain (171 cases), aortic valve incompetence (108), peripheral ischemia (79) and congestive heart failure (63). Hypertension (148 cases) is the commonest underlying cause encountered. Prosthetic replacement of the ascending or descending aorta alone is done in 32 and 22 patients, respectively. Separate graft replacement of ascending aorta and aortic valve are performed in 54 patients. Bentall-De Bono's operation is used in 43 cases. Partial arch replacement is done in 25 patients, and total arch replacement--in sixteen. The early postoperative mortality in patients presenting acute dissecting aneurysms of the aorta is significantly higher (24.77 per cent), as compared to that in patients with chronic aneurysms (6.02 per cent). There is no significant difference in early postoperative lethality, attributable to the location of the process.