The Management of Thoracic Aortic Aneurysms

Abstract

INTRODUCTION:
The Operative Management of Thoracic Aortic Aneurysms remains a major surgical challenge. Problems with maintenance of cerebral and vital organ perfusion, the avoidance of particulate and air embolus during manipulation and excessive postoperative hemorrhage, previously resulted in mortality rates of greater than 40%. With the introduction of safer methods of vital organ support, allied to improved mate rails, an aesthetic and haemostatic techniques, the mortality in these otherwise uniform ally fatal conditions is now 1O%.

CONCLUSION:

Although the surgical management of thoracic aortic aneurysms remains a major challenge, with proper investigation, preparation and intraoperative support, results are increasingly favorable with an acceptable mortality rate. Wherever possible the extra-anatomical shunt should be used to protect vital organ perfusion, due to its ready availability and ease of application.In situations requiring formal support with cardiopulmonary bypass, it is difficult to advise on the superiority of either method, and the choice of method used is dependent on a careful appraisal of the individual case and the preference of the surgeon.