Total arch replacement after a failed repair for Takayasu's ascending aortitis

The constellation of Takayasu's disease most commonly includes aortitis with resultant coarctations and aneurysm formation. Surgical repair of these lesions can be compromised by the chronic inflammation of Takayasu's arteritis. We present a case of a 22-year-old female with Takayasu's disease who had undergone an ascending and aortic hemiarch replacement then subsequently developed anastomotic dehiscence and re-expansion of the previous aneurysmal sac. Complete aneurysm resection and replacement of the ascending aorta and aortic arch was performed on repeated surgery.