One-stage total arch and proximal descending aorta replacement via a single median sternotomy

For extended arch pathologies involving the proximal descending aorta, the exposure afforded by the median sternotomy is less than ideal, and radical replacement of the distal arch by conventional total arch replacement is difficult. We developed a surgical manoeuvre to replace the total arch and proximal descending aorta in 1 stage through a single median sternotomy.