Sufficient perioperative care should be given to high-risk patients who have endografts that cover more than 9 segments and endografts that cover segments from Th8 to Th12. Adequate haemoglobin levels and mean arterial pressure are needed to provide sufficient spinal cord perfusion.

The RA anastomosed to the aorta appears to have good long-term outcomes, similar to the RITA as the second arterial graft. Furthermore, the choice of RA avoids sternal complications and shortens the operation time compared to the use of BITA.

No abstract

Single coronary artery (SCA) in the absence of other major congenital cardiovascular anomalies is rare. We report an extremely rare case of acute aortic dissection in an octogenarian who had a single left coronary artery with the right coronary artery originating from the distal circumflex. A single ostium was incidentally detected by visual inspection during an operation. We diagnosed the anomaly in detail by postoperative 64-slice multi-detector computed tomography. As we performed an emergency operation, it was difficult to recognize SCA preoperatively. In this situation, it is very important to establish adequate myocardial protection and careful dissection is necessary to avoid iatrogenic injury.

We describe the case of a 69-year-old man with a thoracic pseudoaneurysm caused by a diffuse large B-cell lymphoma. He had a large mass inside the aortic arch. Five weeks later, an asymptomatic aneurysm protruding from the minor curvature of the distal aortic arch was observed. We suspected a mycotic pseudoaneurysm and performed total arch replacement with an omental pedicle flap graft. Intraoperative tissue cultures and histopathologic tests identified no bacteria, however. Eventually, a pathologic examination revealed that the structure initially suspected to be an intramural thrombus was a diffuse large B-cell lymphoma.