Frozen Elephant Trunk in Right Aberrant Subclavian Artery

Aberrant right subclavian artery is a relatively rare congenital anomaly of the aortic arch. A 74-year-old woman was referred to our cardiac surgery department for chest pain. Computed tomography angiography scan showed an acute aortic dissection and revealed an aberrant right subclavian artery routed behind the trachea. We performed supracoronary ascending aorta and total arch replacement with the frozen elephant trunk technique. The aberrant right subclavian artery was then anastomosed termino-terminal to one branch of the Thoraflex (Vascutek, Glasgow, Scotland) arch graft. Postoperative computed tomography scan indicated a successful reconstruction of the aortic arch, proving the open stent-grafting technique as a useful and effective approach for aortic disease with aberrant right subclavian artery.