Excision of Saccular Aneurysm of the Thoracic Aorta: A Report of Five Cases

Abstract

The history of the surgery of aortic aneurysm is long, yet it is only in recent years that any progress has been made. Some landmarks may be noted. In 1864, Moore and Murchison described the method of intrasaccular wiring of an abdominal aortic aneurysm which was unsuccessful in this case because of infection introduced at the same time. This method was modified by Blakemore and King (1938), who used an electric current to promote clotting by heating the wire, and by Linton (1952), who stressed the need to insert a sufficient length of wire; Colt (1925) Ochsner (1944, 1952) excised and sutured the base of a small saccular aneurysm of the descending aorta which had been encountered unexpectedly during an operation for a supposed mediastinal tumour. This operation was a complete success, and was the basis for further advances.In the same year Alexander and Byron (1944) reported the successful excision of a saccular aneurysm of the descending aorta. The aneurysm probably arose at the site of a coarctation: 7.5 cm. of the aorta was removed with the aneurysm, and as the collateral circulation was well developed no attempt was made to restore the continuity of the aorta. The patient, a young man, survived for two

Thoracic aneurysms

“…This is major surgery in the truest sense of the word and is not undertaken unless bypass facilities are immediately available. Many saccular aneurysms may be excised following simple clamping of the neck and associated fusiform dilatation treated by reinforcement of the aorta by suturing a suitably tailored dacron sleeve in position (Bickford & Glennie, 1960).…”