Abstract
The thoracic aorta is divided into three segments I-III. This topographic classification is important for surgical strategy and technique since the method of reconstruction used depends on the diseased aortic segment. Lesions of the ascending aorta (segment I) can only rarely be repaired without heart-lung bypass, e.g., in saccular aneuryms or traumatic aneurysms which may be resected by simple tangential clamping. They are discussed in the “Manual of Cardiovascular Surgery” (vol. VI/2, p. 575 ff.). The diseases of the aortic arch (segment II) are treated by orthotopic aortic arch replacement in hypothermic circulatory arrest by use of the heart - lung machine [3, 4, 14]. Localized lesions of the distal portion of the aortic arch may be repaired without the help of the heart - lung machine, using certain modified bypass techniques [9, 17] (Fig. 15.6.3). A prerequisite is an un-diseased aortic segment at least 5 cm long above the aortic valve which can be partially clamped. Segment III, the descending aorta, includes the origin of the left subclavian artery. This whole segment can be clamped distally and proximally without critical impairment of cerebral blood flow.
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Stelter, WJ., Heberer, G. (1989). Aneurysms and Ruptures of the Thoracic Aorta. In: Heberer, G., van Dongen, R.J.A.M. (eds) Vascular Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72942-3_29
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DOI: https://doi.org/10.1007/978-3-642-72942-3_29
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