Surgery for descending thoracic aortic anastomotic aneurysms with a temporary external bypass method

Abstract

The surgical treatment of descending thoracic aortic anastomotic aneurysms is technically challenging. The purpose of this study was to evaluate the use of a temporary external bypass method as an intraoperative measure in the surgical treatment of anastomotic aneurysms of the descending thoracic aorta. An analysis of five consecutive patients who had undergone surgery for a collective seven descending thoracic aortic anastomotic aneurysms in our university hospital over a period of 14 years was conducted. A temporary bypass technique was used as an intraoperative measure in all the operations, four of which were performed with a right axillary to left external iliac artery bypass, while other sites were used in the remaining three. Systemic heparinization was able to be avoided in six operations and was markedly reduced in the remaining one. Although the major postoperative complication was coagulated hemothorax after six procedures, all patients recovered well and are still alive after a mean follow-up period of 8.2+/-1.5 (SEM) years. The results of this analysis led us to conclude that our temporary bypass method for treating descending thoracic aortic anastomotic aneurysm prevented the risks of anticoagulant administration for circulatory support, which contributed to the success of the operation. This method can be used as adjunct treatment for anastomotic aneurysms in the descending thoracic aorta.