Successful Management of Acute Type A Aortic Dissection in a 305 kg Patient Using Two Oxygenators in Parallel.

Patient factors can present formidable challenges in emergent aortic surgery. We report successful mechanical aortic root, ascending aorta, and Zone 2 arch replacement under hypothermic circulatory arrest in a 305 kg patient with acute type A aortic dissection. A dual-oxygenator bypass circuit, proactive metabolic management, bilateral fasciotomies, and early renal replacement therapy were critical to a favorable outcome.