Staged resection of a life-threatening aneurysm of the descending thoracic aorta and a coexisting aneurysm of the ascending aorta

The authors report the successful staged resection of a descending thoracic aortic aneurysm and a coexisting ascending aortic aneurysm. The main challenge was to provide optimal proximal aortic decompression to prevent rupture of the ascending aorta during the distal repair. During the period of aortic arch cross-clamping, organ protection was achieved with a Gott shunt inserted proximally in the aortic arch and distally in the left common femoral artery. The importance of this shunting procedure, which has been the basis of our surgical technique in the treatment of all lesions of the descending thoracic aorta, is emphasized.