Frozen Elephant Trunk Repair for Acute Type A Dissection in Right Aortic Arch.

Abstract

A 68-year-old woman with a right aortic arch and an aberrant left subclavian artery underwent urgent operation for type A aortic dissection. Surgical management included total arch repair with the frozen elephant trunk technique and left subclavian artery reimplantation. Her postoperative course was complicated by severe renal failure, delirium, and pneumonia. She underwent reoperation 3 weeks later for an expanding proximal aortic anastomosis pseudoaneurysm. Right aortic arch is a rare vascular anomaly requiring thoughtful preoperative planning for adequate myocardial, cerebral, and spinal protection. The frozen elephant trunk technique facilitates management of extensive dissection, relieves malperfusion, and may alleviate the need for subsequent operations.