[A case report of ruptured distal aortic arch aneurysm into pericardial space].

We report a case of successful total aortic arch replacement using selected cerebral perfusion for ruptured distal aortic arch aneurysm (DAAA) into the pericardial space. A 75 year-old man who had preoperative episode of severe chest pain and tachycardia was transferred to our hospital. Computed tomography showed saccular DAAA and pericardial effusion, so the patient was diagnosed as ruptured DAAA into pericardial space. Immediately after CT-scanning, urgent operation of a graft replacement of aortic arch with selective cerebral perfusion was carried out. Postoperatively, he had no cerebral complication, but develop transient respiratory failure and renal dysfunction. Three months after the operation he was discharged from the hospital. The patient is now leading a normal life.