Extended Cervical Access for Cerebral Malperfusion in Acute Aortic Dissection in a Circulatory Unstable Patient.

A 63-year-old man who had acute aortic dissection type A with signs of cerebral malperfusion and hemodynamic instability underwent immediate carotid artery cannulation. A Bentall procedure and total arch repair with frozen elephant trunk implantation were performed with extended cervical access to address supraaortic vessel involvement. We demonstrate that prudent cannulation and repair strategies can be successful even in the most complicated cases of aortic dissection.