[Total arch replacement for dissecting aneurysm using permanent bypass to the supra-aortic branches and left-heart bypass].

The patient was a 36-year-old women with Marfan syndrome who had received graft replacement of ascending aorta for Stanford-type A dissecting aneurysm two years ago. She was re-operated on for residual arch and descending aortic dissection. We have found that it was Simple and effective to perform total arch replacement by using permanent bypass to the three principal supra-aortic branches and left-heart bypass.