Is There a Place for Wall Reinforcement in Modern Aortic Surgery?

Possible applications of wall reinforcement in aortic surgery are presented. "External grafting" is recommended in conjunction with aortic resections and graft replacements, or under special circumstances, as an independent procedure.

The authors have applied the principle of external grafting in 142 instances under the following circumstances: (1) in conjunction with aortic resections; (a) reinforcement of the proximal suture line and the aortic stump (83 cases); (b) aortic wall reinforcement following subtotal resection of aortic aneurysm involving the origin of the renal arteries (16 cases); (2) as an independent procedure; (a) small fusiform aneurysm; (b) aneurysms of moderate-to-medium size in delibilitated persons, especially if the arterial "run off" was poor; (c) fusiform aneurysms of the thoracic aorta of moderate size (42 cases of 2, a, b, and c); (d) fusiform dilatation of the entire aortic arch (1 case). Observations, a few of which have exceeded three years, have revealed no aortic ruptures.