Single graft “peninsula-style” transverse aortic arch replacement in patients with type A acute aortic dissection: case report

Acute type A aortic dissection, despite treatment advances, remains a critical emergency with markedly high morbidity and mortality rates. The primary goals of immediate surgical intervention are to ensure survival, prevent severe complications, and avoid subsequent interventions. We present a case of a 55-year-old male who presented with new-onset chest pain, dyspnea, and hypotension. Emergent transthoracic echocardiography and subsequent computed tomography revealed an ascending aortic dissection. The patient underwent immediate surgical repair using a "peninsula-style" technique for transverse arch replacement with a single piece of Dacron graft, preserving continuity with the proximal descending aorta and performing routine aortic valve commissural resuspension. Following an uncomplicated postoperative course, he was discharged in a stable condition, and an 18-month follow-up CT showed no signs of aorta-related complications. This case report underscores the importance of having specialized thoracic aortic teams capable of using easily reproducible techniques, reducing operative time, and yielding reliable results.