[Total Arch Replacement via Right Hemicollar Incision and Mediansternotomy for an Arch Aneurysm with an Aberrant Right Subclavian Artery].

The patient was 72-year-old-woman. Computed tomography( CT) revealed an arch aneurysm with an aberrant right subclavian artery (ARSA). We performed total arch replacement via right hemicollar incision and median sternotomy. Arch replacement and right subclavian artery reconstruction were performed under hypothermic circulatory arrest with selective cerebral perfusion. This approach allowed selective perfusion and reconstruction of the ARSA in the same field of view as total arch replacement. Because the right side was non-recurrent laryngeal nerve, we were able to perform the surgery without concern for bilateral recurrent nerve palsy. The patient had no cerebral complication and her postoperative course was uneventful.