Thoracic aneurysm in association with an aberrant right subclavian artery.

A case of a 45-year-old man is presented with clinical signs of a dissecting aortic aneurysm. Angiography and CT demonstrated a dissecting thoracic aneurysm (deBakey type III a) and an aberrant right subclavian artery arising from this aneurysm at the fourth branch of the aortic arch. In the first step, the aberrant artery was implanted into the right common carotid artery. In a second operation, the aneurysm was replaced by a Dacron tube. The advantage of our procedure is the perfusion of at least one vertebral artery during aortic cross-clamping and easier access to the aneurysm through a left thoracotomy. As far as we know, this is the fourth presentation of such a case in the literature in which the other cases concern angiographic or post-mortem findings.