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Michael E. De Bakey, M.D.; Denton A. Cooley, M.D.
JAMA. 1954;155(16):1398-1403. doi:10.1001/jama.1954.03690340020007.
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During the past few years, increasing interest has been aroused in excisional therapy for aneurysms of the aorta. In general, two types of procedures have been developed for this purpose, namely, tangential excision with repair of the resultant defect by lateral aortorrhaphy and resection of the involved segment of aorta with restoration of continuity by aortic homograft.1 While the former procedure may be employed for sacciform aneurysms located in any part of the aorta, including the arch, there are definite limitations to application of the latter procedure in this respect owing to the potential ischemic effect of temporary arrest of the circulation from cross clamping of the aorta during its performance. Obviously, the more proximal the lesion, the greater is the likelihood of ischemic damage to vital organs from this procedure. Accordingly, this problem assumes particular importance for lesions located about the aortic arch and has, therefore, seriously limited the


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