Staged Hybrid Repairs of Acute Type A Aortic Dissection Involving the Right Aortic Arch with Retroesophageal Aortic Segment

IntroductionSurgery for type A aortic dissection associated with right aortic arch is complicated because of the anatomical relationship of the aorta with the trachea and oesophagus.ReportA 67-year-old man having right aortic arch with a retroesophageal aortic arch segment suffered an acute type A aortic dissection. An intimal tear located just proximal of the Kommerell’s diverticulum. Total arch replacement and an elephant trunk insertion to cover the primary intimal tear were performed. Three months later, endovascular repair was carried out to close the primary intimal tear.DiscussionHybrid repair is the appropriate way for such an unapproachable case.