Dissecting thoracoabdominal aortic aneurysm associated with an isolated right-sided aortic arch

Although a right-sided aortic arch is not a rare anomaly, an aortic dissection involving an isolated right-sided aortic arch is extremely rare and remains a complicated entity for surgical therapy because of its anatomical characteristics. Previous reports that we have identified in English literature include only six surgical cases of aortic dissection involving a right-sided aortic arch. We report on a 75-year-old female who had a chronic thoracoabdominal aortic aneurysm following type B aortic dissection in a right-sided aortic arch. Graft replacement including reconstruction of Adamkiewicz artery and a celiac trunk was performed. The postoperative course was uneventful except for a prolonged ventilatory support. This case seems to be the first successful case of extended graft replacement for this pathology.