OBJECTIVE

To choose the optimal surgical approach for reconstruction of thoracoabdominal aorta (TAA).

MATERIAL AND METHODS

There were 82 thoracoabdominal aortic repair procedures for TAAA Crawford type II and III, as well as mega-aorta between 2018 and 2021. We used 2 main approaches for reconstruction of the most extensive and common thoracoabdominal aortic aneurysm Crawford type II. It is thoracophrenolumbotomy in the 4^th intercostal space with intersection of the underlying ribs and alternative approach in the 4^th and 6^th intercostal spaces.

RESULTS

Access through the 4^th intercostal space with intersection of the underlying ribs is more convenient for surgeon. This approach has significantly better spatial relationships in the wound: lower wound depth and greater operative action angle (p<0.05). However, thoracophrenolumbotomy in the 4^th and 6^th intercostal spaces is less traumatic for patients, since it preserves ribs and ensures satisfactory spatial relationships in the wound.

CONCLUSION

Both accesses provide good conditions for TAA reconstruction. A particular approach can be used in each case depending on surgical preferences.