XXXX of the descending thoracic aorta: treatment with the Gott shunt.

@entity1 @entity712 @entity548 @entity2634 @entity177 @entity520 @entity439 @entity1167 @entity451 @entity204
In the repair of @entity439 of the descending thoracic aorta, interruption of aortic flow has usually been accomplished by cardiopulmonary bypass, which has been associated with excessive @entity548 due to the systemic heparinization required. To avoid this problem, the authors have used an external (Gott @entity439 ) shunt, which does not require systemic heparinization. In 50 @entity1 with an @entity439 of the descending thoracic aorta a Gott @entity439 shunt was used as an external bypass. The shunt is a flexible, transparent, @entity2634 tube and its heparin-coated wall prevents clotting. Forty-two (84%) @entity1 survived the operation. Thirty-two @entity1 had surgical repair of a traumatic rupture of the descending aorta; 29 (91%) survived. Of 18 @entity1 operated on for an arteriosclerotic @entity439 or a DeBakey type III dissection 13 (72%) survived. Most of the @entity204 occurred early in the series; among the last 14 @entity1 treated for an arteriosclerotic @entity439 or dissection 13 (93%) survived. @entity451 occurred once (2%) because a shunt was accidentally introduced outside the lumen of the descending aorta and therefore did not function. Another @entity1 with an acutely transected aorta and @entity548 had rapid cross-clamping of the aorta without a shunt but suffered a @entity1167 due to postclamping @entity520 . He was successfully resuscitated. No @entity712 , @entity451 or @entity177 occurred in the 48 @entity1 properly protected with the Gott @entity439 shunt. Regardless of their etiology, thoracic @entity439 are unpredictable and the authors recommend surgical treatment in most @entity1 , using this external bypass technique as a method of organ protection.
