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February 1958

Resection of Aneurysm of Thoracoabdominal Aorta: Involvement of Celiac and Superior Mesenteric Arteries, with Rupture into Psoas Muscle

Author Affiliations

New York
From the Surgical Division, the Montefiore Hospital.

AMA Arch Surg. 1958;76(2):239-246. doi:10.1001/archsurg.1958.01280200061007

The major technical problem in the excisional therapy of aneurysms involving the thoracoabdominal aorta is ischemia of vital organs during the construction of new anastomoses to any combination of the celiac, superior mesenteric, and renal arteries. While the duration of complete occlusion of these vessels compatible with healthy survival is not known definitely in man, it is reasonable to assume that the shorter the periods of visceral anoxia the better for the patient. In some instances it has been possible to obtain a relatively brief period of occlusion of the visceral arteries, i. e., 37 minutes, by tangential excision of the aneurysm and reconstruction of the aorta by lateral sutures, as reported by Bahnson.1

DeBakey and co-workers were the first successfully to apply the principle of a temporary by-pass shunt during resection of the aneurysm and replacement by a homograft.2 This operation was performed on three patients, two

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