LATE COMPLICATIONS AFTER SURGICAL EXCLUSION OF THE THORACIC AORTA

Two patients who underwent surgical exclusion of the thoracic aorta fo r chronic dissecting aneurysms of the descending aorta died 4 and 8 ye ars after surgery due to complications in part related to the operativ e technique. One patient developed pseudoaneurysm of the proximal aort ic stump with fatal exsanguination through an aortapulmonary fistula. The other patient developed progressive dilatation of the remaining ab dominal aorta with subsequent rupture. The surgical approach in this c ase was extremely difficult because of the previous exclusion procedur e which determined a highly demanding reoperation. Although surgical e xclusion of the thoracic aortic may be a useful technique in some situ ations, we must be aware of its early and late complications and, in o ur opinion, it should be seen only as an alternative treatment for ver y special patients with diseases of the descending thoracic aorta.