Novel surgical incision for treatment of extensive aortic aneurysm: a case of straight incision with rib-cross (SIRC) approach.

Spiral incision of the thoracic wall through the 5th or 6th intercostal space has been a standard approach for thoracoabdominal and descending aorta replacement (Interact Cardiovasc Thorac Surg 18:278–282, 2014). The exposure of the proximal lesion, however, is often insufficient for patients with a flat chest. In this connection, Asian patients tend to have a narrower chest cavity and the flat chest is frequently seen in Marfan syndrome patients. A novel straight incision with rib-cross approach was applied for such a patient with a narrow or flat chest to make aortic repair easier and safer. We herein present a case of a 37-year-old male diagnosed with extensive aortic aneurysm associated with chronic aortic dissection, who underwent one-stage repair of the aortic arch and thoracoabdominal aortic aneurysm via a novel surgical incision.