First attempts without cardiopulmonary bypass.
The first surgical approach was due to Beck4 in 1944. He incised the pericardium around the aneurysm leaving the pericardium adherent to the lesion. A fascia lata graft was then sutured to the adherent pericardium and plication sutures were taken centrally to reduce the size of the aneurysm and graft. The patient died five weeks later with empyema and encephalomalacia. In 1955 Likoff and Bailey5 described a case successfully treated with a tangential exclusion with a specially designed side clamp. In 1958 Bailey6 reported 6 similar cases with 5 survivors. As the problem of embolization could be easily controlled flushing out the thrombi, if any, the Authors concluded that the use of an open technique using cardiopulmonary bypass was not justified.