SURGICAL TREATMENT OF DISSECTING ANEURYSM

Dissecting aneurysm of the aorta is associated with a grave prognosis, but recently a method has been developed that seems to offer an effective surgical approach to the problem. The underlying predominant lesion is degeneration of the elements of the media. The dissection commonly begins as a transverse tear in the intima and media in the ascending aorta or descending limb of the aortic arch near the origin of the left subclavian artery. Separation of the intramural layers of the aorta by the forceful stream of blood produces dissection involving all or a portion of the circumference of the aorta. Surgical treatment is directed toward correction of the dissecting process by removal and repair or interruption of its progress by creation of conditions compatible with function and eventual repair. One of two methods may be used, the first when the dissection originates in the ascending aorta and the second when