Four cases with ascending aortic aneurysm-two saccular aneurysms, one with dissecting aneurysm of DeBakey's type I and one with aneurysmal dilatation of the ascending aorta associated with aortic regurgitation-successfully operated upon by means of cardiopulmonary bypass, are presented, and the special considerations of surgery of these conditions are described. Additional Indexing Words: Ascending aortic aneurysm Cardiopulmonary bypass Coronary perfusion Carotid perfusion URGICAL treatment of

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... he ascending aortic aneurysm is one of the most difficult cardiovascular operations. The authors have experienced 4 surgical cases with ascending aortic aneurysms which conditions were different from each other. The purpose of this paper is to report the clinical results and to describe the methods of cardiopulmonary bypass applied to these patients, respectively. CASE REPORTS Case 1. A 52-year-old woman had complained of shoulder and chest pain since 7 months ago, and she had undergone the exploratory thoracotomy under the diagnosis of the lung cancer one month before admission at the other hospital. Physically, aortic pulsations were palpable and systolic murmurs, Grade 2/6, were audible at the 2nd and 3rd intercostal spaces along the right sternal border. Chest Xray films revealed an anterior mediastinal mass and angiocardiograms taken after injection of the contrast medium into the pulmonary artery demonstrated simultaneous opacification of both the ascending aorta and the tumor (Fig.1, a, b) . Operation was performed on May 31, 1968. The aneurysm was approached through a median sternotomy and it adhered firmly to the right lung. The aneurysm