Since Jan/91 we have been using the "open distal" technique (ODT) described by Cooley, for surgical treatment of diseases of the descending thoracic and thoracoabdominal aorta. From jan/91 to jan/95, the technique was used in 35 instances (25 for descending aorta and 10 for thoracoabdominal aorta). Degenerative aneurysms and aortic dissections had similar incidence in this group (48.5% and 40.0%, respectively). In 8 patients the aorta was ruptured which was partially occluded by the lung (5 cases), abdominal organs (2 cases) and esophagus (1 case). Surgical exposure was obtained either by left thoracotomy or thoraco-phreno-laparotomy. Heparin was used in a dosis of 1.5 mg/kg and all the blood was collected from the patient and returned through the femoral vein. There were 4(11.4%) hospital deaths and 2 (5,8%) patients with thoracoabdominal aneurysms developed paraplegia. Morbi - mortality of the group was related to the pre-operative clinical condition and extension of the disease. In our opinion ODT is a simple and effective surgical technique for diseases of the descending thoracic and thoraco-abdominal aorta. Maybe for extensive resections with long aortic cross clamping time, other methods providing a better spinal cord protection should be evaluated