Descending aortic aneurysmectomy without adjuncts to avoid ischemia.

Encouraged by reports on the safety of simple aortic cross-clamping for resection of descending aortic aneurysm, we began utilizing this technique more liberally in 1976. This study was undertaken to examine the results of operation in 36 patients, equally divided into two distinct groups. In Group 1, either extracorporeal circulation or indwelling temporary shunts were employed during the period of aortic occlusion. In Group 2, simple aortic cross-clamping was utilized to manage the lesion. No adjuncts were used to avoid ischemia in the latter group. The only 2 early deaths and two instances of paraplegia occurred in Group 1. In general, there were fewer complications in Group 2, with approximately two-thirds of the patients experiencing an uneventful postoperative course. These differences are considered important since the two groups were similar in respect to the extent and nature of the lesions and other factors contributing to operative risk.