Surgical treatment of the aortic aneurysm.

For 93 cases of thoracic and 118 cases of abdominal aneurysms, the over-all operative mortality rate was 24.7 per cent and 9.3 per cent, respectively. Although the over-all operative mortality rate for 37 patients with aneurysms of the ascending aorta or aortic arch had been 40.5 per cent, recent advances in surgical technique led to a higher survival rate so that since 1975 no death occurred among 14 consecutive surgery cases. Cardiopulmonary bypass with or without selective perfusion of the carotid arteries or temporary external bypass procedures were employed in these 14 cases. The over-all operative mortality rate for 56 patients with aneurysms of the descending thoracic aorta was 14.3 per cent. Temporary external bypass procedures were employed in 49 cases. The operative mortality rate for 99 patients with unruptured abdominal aneurysms was five per cent, and that for 19 patients with ruptured aneurysms was 31.5 per cent.