Surgical treatment of basilar artery aneurysms. Elective circulatory arrest with thoracotomy in 12 cases.

✓ The authors report a technique to aid in the surgical treatment of patients with basilar artery aneurysms. Under moderate hypothermia a nondominant temporal craniotomy and small anterior temporal lobectomy are performed. After median sternotomy is done and ventricular fibrillation is induced, microscopic dissection around the aneurysm proceeds for 4 minutes. If more time is needed, manual cardiac systole is performed for 60 seconds. This has been repeated for as long as 28 minutes, with an average of 9 minutes of arrest. After the aneurysm has been treated, normal sinus rhythm is restored in the heart. The operative technique and 12 case histories are presented. There were two deaths among the early cases. All others have done well.