Concomitant David's operation and total arch replacement for acute type A aortic dissection.

A 61-year-old man complained of chest pain and developed congestive heart failure due to massive acute aortic regurgitation. Computed tomographic scan demonstrated Stanford type A aortic dissection from the aortic root to common iliac arteries. David's aortic valve sparing operation and total aortic arch replacement were applied to the patient, because the aortic dissection was extended into two aortic commissures and all arch vessels, though the tear was present at the proximal ascending aorta. The surgery was well tolerated without any significant complication.