[Result of surgery for aneurysms of distal aortic arch and proximal descending aorta].

We examined the surgical result for non-dissecting aneurysm of distal aortic arch and proximal descending aorta, for which aneurysm, proximal aortic clamp cannot be set at descending aorta because of the proximal progression of aneurysm. In 25 cases out of all 46 cases for 18 years, before 1990, aortic arch was clamped for proximal aortic control with the aid of temporary bypass, femoral artery-vein bypass or left heart bypass (clamp group). In 10 cases proximal aortic clamp was set between innominate and left common carotid artery and in 15 cases between left common carotid artery and left subclavian artery. In the former, temporary or permanent bypass was made to left common carotid artery. After 1990, in 21 cases, aortic arch was not clamped with the aid of separate cerebral perfusion (no clamp group). In the comparison of surgical result between two groups, no clamp group showed less postoperative complication rate in brain damage (28% vs 14%) and bleeding (16% vs 5%) and showed better operative mortality (20% vs 14%) and better hospital mortality (32% vs 19%). Now, in the surgery for non-dissecting aneurysm of diatal aortic arch and proximal descending aorta, it is preferable not to clamp aortic arc, employing separate cerebral perfusion.