Total arch replacement for incomplete double aortic arch associated with patent ductus arteriosus in an adult.

The patient was a 52-year-old man. A plain chest radiograph showed widening of the superior mediastinum. Three-dimensional computed tomography revealed a thoracic aortic aneurysm involving an incomplete double aortic arch (Stewart's IB type 4) with a patent ductus arteriosus. An aneurysmectomy with replacement of the ascending aorta, aortic arch and the descending aorta and reconstruction of four cervical arteries was performed with extracorporeal circulation and selective cerebral perfusion. To our knowledge, this is the first report to document the surgical repair of a thoracic aortic aneurysm involving a Stewart's IB type 4 double aortic arch in an adult.