Aneurysms of the thoracic aorta can be classified as congenital, acquired, or false ( pseudoaneurysms). Awareness of the entity of pseudoaneurysm will facilitate a correct diagnosis by simple radiographic interpretation. Congenital and acquired thoracic aortic aneurysms must be differentiated from pulmonary and mediastinal tumors. The exact diagnosis and nature of such lesions is best elucidated by an aortogram. Intravenous aortography is simpler and safer than direct retrograde catheter techniques, but does not provide as accurate visualization as does the latter technique. Left heart bypass has greatly facilitated the surgical repair of these lesions. Refinements in this technique such as the use of an open reservoir and maintenance of normal proximal aortic pressures will provide near normal renal and spinal cord blood flow while safely decompressing the left ventricle for periods of several hours of aortic crosselamping.
Connolly JE. Diagnosis and Treatment of Thoracic Aneurysms. JAMA. 1962;179(8):615–619. doi:10.1001/jama.1962.03050080027006
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