Departments of 1Cardiothoracic Surgery and 2Diagnostic and Interventional Radiology,

Purpose: To describe the use of a hybrid frozen elephant trunk technique to treat a patient suffering from a multisegmentally diseased, dextropositioned aortic arch and right descending aorta. Technique: The technique is illustrated in a 58-year-old woman who was diagnosed with chronic type A aortic dissection in a right aortic arch and descending aorta; a lusoric left subclavian artery passed behind the esophagus. Aneurysmal dilatation of the arch and descending aorta required treatment. A frozen elephant trunk procedure was performed in a single stage via a median sternotomy using a hybrid Chavan-Haverich endograft, with complete surgical replacement of aortic arch. The stents for the endograft were placed in the descending aorta in an antegrade fashion through the opened aortic arch. Conclusion: This case demonstrates the feasibility of treating complex pathologies of the thoracic aorta even in cases of aberrant anatomy. A conventional 2-stage approach for treatment of the complex pathology could have been complicated due to difficulties with exposure. J Endovasc Ther. 2010;17:751–754 Key words: thoracic aortic dissection, endovascular repair, frozen elephant trunk