Resection of aneurysm of the aortic arch without cardiopulmonary bypass

Four cases of aneurysm of the aortic arch were encountered within 1 year at the National Taiwan University Hospital, Taipei, Taiwan, Republic of China. All four patients underwent resection of the aneurysm and graft replacement of the aortic arch without cardiopulmonary bypass or hypothermia. Temporary external shunting with Tygon tube from the ascending aorta to the femoral artery, with and without permanent bypass grafts from the ascending aorta to the carotid arteries, was used in three patients. Permanent bypass grafts with multiple anastomoses was used in one patient. The over-all operative mortality rate was 25 percent. Some adjuncts are made to perfect the safe and simple technique of temporary external shunting, which has been reported previously from the same institution.