Single stage thoracic aortic replacement and aortic valve replacement via clamshell thoracotomy.

Aortic surgery is sometimes complicated by aortic arch anomalies. This tutorial illustrates the technique of single-stage thoracic aorta replacement and aortic valve replacement via a clamshell thoracotomy in acute aortic arch dissection with proximal aneurysms of the left subclavian artery and an aberrant right subclavian artery. The advantage of this technique is that only brief partial hypothermic circulatory arrest is required and the procedure can be performed with one quadrifurcated tube graft.