• Journal of Chest Surgery
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• 제27권10호
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• pp.862-867
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• 1994

We experienced two cases of dissecting aneurysm[DeBakey type III] of the thoracic aorta treated using intraluminal sutureless graft. Controversy still exists about the exact timing of surgical intervention for dissection of the descending thoracic aorta. The surgical indication of dissecting aneurysm[DeBakey type III] is continuous flow in the false lumen, continuous chest pain, compromise of arterial supply to a specific organ or limb, or extension of the dissection while the patient is receiving satisfactory medical treatment. Surgical therapy for dissection of the aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. Recently, a new method of treatment with a intraluminal sutureless graft that requires no end-to-end anastomosis has been developed. In our cases, cardiopulmonary bypass and circulatory arrest was utilized in repairing dissecting aneurysm of descending aorta[DeBakey type III] in order to avoid the aortic cross clamping because of friable aortic intima. The basic technique consists of vertical incision of descending aorta in the area of intimal tear and inserting the whole ringed graft into the true lumen of the dissected aorta and circumferentially ligating the aorta against the groove in the rings. Postoperative course was uneventful.