[A case report on two stage operation of dissecting aneurysm of DeBakey IIIb type associated with dense pulmonary adhesion].

Successful surgical treatment of chronic dissecting aneurysm (DeBakey IIIb type) in a 50-year-old man was reported. His left lung was tightly adhered to the aneurysm and the chest wall, because he had a previous operation history for pyothorax. This patient showed copious pulmonary bleeding by the pulmonary injury during adhesiotomy. We selected the two stage operation for deducting operation risks, and finished the first operation at the end of adhesiotomy. Some pieces of e-PTFE sheet had been put between lung and thoracic wall, or aneurysm. After a week, waiting the cure of this pulmonary injury, the second operation was performed with a small quantity of pulmonary bleeding. There wasn't fresh pulmonary adhesion because of protection by e-PTFE sheet. The two stage operation was useful in cases associated with dense pulmonary adhesion.