Repair of descending thoracic aortic dissection or aneurysm combined with repair of the proximal aorta via median sternotomy

A single-stage procedure for repair of the whole thoracic aorta via median sternotomy is described. The procedure is based on exposure of the descendi ng aorta, posterior to the pericardium in the oblique sinus, or exposure of the aorta in the supracoeliac region and the placement of an endoprosthesi s as an intraluminal graft. The ascending aorta and arch repair can be carr ied out as usual. The procedure has been performed in five patients with ei ther dissection or aneurysm in the period between 1992 and 1997.