Simultaneous repair of multiple aortic aneurysms: be courageous in minimally invasive era

The simultaneous treatment of multiple ruptured aortic aneurysms is a surgical challenge. Here we present a case of a 53-year-old woman with Marfan syndrome who had annuloaortic ectasia of 4.2 cm and a thoracoabdominal aortic aneurysm of 6 cm. The patient developed acute aortic dissection complicated with cardiac tamponade and thoracoabdominal aortic rupture. An emergency operation, which included a Bentall operation, total arch replacement, and thoracoabdominal repair, was performed for 2 remote aneurysms. By paying particular attention to organ perfusion, a single-stage operation was successfully performed and the patient fully recovered.