WHEN aneurysms of the descending thoracic aorta are resected the aorta must be cross-clamped. The clamp usually is applied just distal to the left carotid artery with a separate clamp on the left subclavian artery. During the period of aortic occlusion the blood supply to the lower part of the body must be maintained to prevent ischemic injury to the spinal cord and distal organs and to avoid acute left heart failure.
An external shunt which does not require systemic heparinization has been employed in 11 patients during resection of descending thoracic aneurysms and in two patients after acute traumatic rupture of the descending thoracic aorta in the past two years. We have found this technique simpler and safer in our hands than previously used methods.
A left posterolateral thoracotomy is performed through the fourth intercostal space. Polyethylene catheters are placed around the aortic arch just distal to
Kahn DR, Vathayanon S, Sloan H. Resection of Descending Thoracic Aneurysms Without Left Heart Bypass. Arch Surg. 1968;97(2):336-340. doi:10.1001/archsurg.1968.01340020200024