J.Jpn. Surg. Soc.. 79(9): 1149-1154, 1978

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Report on the annual meeting

SURGERY OF THORACOABDOMINAL AORTIC ANEURYSM

Thoracoabdominal aneurysm continues to be a major challenge in vascular surgery. During the past 12 years the authors treated three patients with aneurysm involving all the abdominal visceral branches, which represents 5.5% of all the aortic aneurysms treated during the same period.
In this cine the emphasis was made on an alternate method of the arterial reconstruction employed in the recent case, 37 y.o. female with a 20 X 10 cm pulsatile abdominal mass associated with moderate dissecting aneurysm of the discending thoracic aorta. The first of these technical points is concerned with proper anatomic exposure.
Another technical point is a simplified reconstructive procedure for which only a 25 mm straight woven Dacron graft was used. A cuff of aorta containing both the celiac and superior mesenteric arteries was sewn to a window taken out of the Dacron graft. Both renal arteries were sutured to circular opeings made in the graft. This limited experience indicates the feasibility of safe therapy employing simpler techniques than generally advocated. Among 13 cases reported as successfully treated in this country only two cases are with reconstruction of all the major visceral arteries. And the case presented here, p.o. 1 year, is only one alive at the present writing.
In conclusion the authors stress that "from complexity to simplicity" would be the most important approach in order to improve the results in this field of surgery.

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