Aortic arch replacement by posterolateral exposure.

Aortic arch replacement was carried out in a 54 year old male patient with an unexpected type A-dissection, using partial femoro-femoral bypass and hypothermic arrest, through a left side posterolateral thoracotomy. After the replacement of the aortic arch from the ascending to the descending aorta a warm-up perfusion was done through an 8 mm side arm Dacron prosthesis attached to the descending segment of the 30 mm Dacron graft. This technique was demonstrated to be safe and protective in our patient and can be used as an alternative surgical method in the treatment of aortic arch dissection or aneurysms of the transverse aortic arch.