[Replacement of the total thoracic aorta in a single stage using selective cerebral perfusion]

A 73-year-old male was admitted with complaints of a sense of back compression and diagnosed as impending rupture of chronic type B dissection and arch aneurysm by CT and angiogram. With the aid of extracorporeal circulation, selective cerebral perfusion and open distal anastomosis, the total graft replacement of the ascending aorta, aortic arch and descending aorta was performed in a single stage via median sternotomy. The angiogram two months after surgery showed that false lumen in the thoracic aorta was obliterated and the patient had recovered well without any cerebral complications. The approach to replace the total thoracic aorta via median sternotomy without left thoracotomy may contribute to reduce respiratory complications after surgery.