Aortic valve reimplantation combined with total arch replacement in type A aortic dissection

We present simultaneous aortic valve reimplantation, replacement of aortic arch, right common carotid artery and proximal parts of the right subclavian and left common carotid arteries in a patient with type I aortic dissection. Involvement of supra-aortic arteries is the main predictor of cerebral malperfusion and mortality in acute aortic dissection. Optimal surgical intervention in such patients is still unclear. Moreover, patients with acute ascending aortic dissection rarely undergo valve-sparing surgery, since such interventions require much time and prolong myocardial ischemia.