Ascending aorta-infrarenal abdominal aorta bypass was performed in 8 patients: 4 patients with dissecting aortic aneurysm, 3 patients with thoracic aneurysm and 1 patient with stenosis of the thoracic aorta after grafting for congenital thoracic aneurysm. Four patients who had aortic dissection underwent the thromboexclusion method, but thromboexclusion of the thoracic aorta occured in only one patient after additional clamp to the distal thoracic aorta. He is the only long-term survival in this series. The thromboexclusion method was also performed in two patients with infectious thoracic aortic aneurysm, but they died of aneurysmal rupture within 13 months after operation. One patient who undewent resection of a thoracic aneurysm with extra-anatomic bypass, developed respiratory insufficiency and paraplegia, and died of pneumonia. The patient with thoracic aortic stenosis is alive and well 11 years after operation. The indications of the thromboexclusion method for thoracic aneurysm should be limited only to very poor-risk patients who seem to be inaccessible to a direct approach. Ascending aorta-abdominal aorta bypass is recommended in cases of thoracic aortic stenosis.

In this review, we discuss in detail our current procedure for treating craniosynostosis using multidirectional cranial distraction osteogenesis (MCDO). The MCDO method allows all phenotypes of skull deformity to be reshaped by distraction osteogenesis, except in patients who are 5 months of age or younger and patients with posterior cranial vault problems. We report the results of clinical data of 36 children with craniosynostosis who underwent MCDO between 2005 and 2014 in our institute. This method has the following benefits, such as a high flexibility of reshaping, shorter treatment period and less invasive secondary intervention. We also discuss the other distraction osteogenesis techniques that are used to treat craniosynostosis and compare them with MCDO. The preferred procedure for correction of craniosynostosis may depend on the patient's age, the extent of deformity, and the extent of correction achievable by surgery. We can arrange the combinations of various methods according to the advantage and disadvantage of each technique.
Child ; Congenital Abnormalities ; Craniosynostoses ; Humans ; Osteogenesis, Distraction* ; Phenotype ; Pliability ; Skull