Hybrid repair of an aortic arch aneurysm rupture in a redo sternotomy

Purpose: To report a case of operative intervention for an aortic arch aneurysm rupture via a hybrid approach. Methods and Results: Ten years after successful open repair of an acute type A aortic dissection a male presented with a rupture of his distal aortic arch aneurysm. A hybrid procedure was carried out which involved debranching of the innominate and left common carotid arteries and stent-graft deployment landing proximally into the ascending aorta and distally into the descending thoracic aorta. Conclusions: Ruptured aortic arch aneurysms present a challenging and complex surgical dilemma. Open repair carries high mortality and pure endovascular repair is unfeasible; hence a hybrid repair presents an attractive solution.