Total arch replacement with frozen elephant trunk for distal arch aneurysm with aberrant right subclavian artery after type B aortic dissection

Aberrant right subclavian artery (ARSA) is a congenital vascular anomaly occurring in 0.5% to 1.8% of the general population, frequently associated with aortic aneurysms.1 We describe a 70-year-old man who developed a rapidly enlarging aortic arch aneurysm involving ARSA after Stanford type B acute aortic dissection. The patient successfully underwent total arch replacement plus frozen elephant trunk (FET) with ligation at the origin of the ARSA. This research was approved by the Ethics Committee of Mitsubishi Kyoto Hospital (approval no.