[A surgical treatment of ruptured arch aneurysm]

A 83-year-old woman was admitted to our hospital because of back pain and shock. Her chest X-ray and CT scan demonstrated a large arch aneurysm and hemothorax, suggesting ruptured aortic arch aneurysm. The ruptured aortic arch aneurysm was replaced with a woven Dacron graft under selective cerebral perfusion (SCP). Her postoperative course was uneventful without any neurological deficits. For the past three years, we have utilized SCP in 12 cases of arch aneurysms. There were three early deaths in this series. The cause of death were bleeding in one patient and cerebral accident in two patients. The latter two patients had severe atheromatous changes in the aortic wall. The SCP technique was a useful method of cerebral protection, especially for elderly patient with aortic arch aneurysm.