Giant Ascending Aortic Aneurysm Presented with Acute Onset Superior Vena Cava Syndrome

We present a case of a 50 year-old-male patient with past history of tissue aortic valve replacement presented at the emergency department with chest pain and acute onset superior vena cava syndrome. After physical examination and CT aortic angiogram a giant ascending aortic aneurysm complicated with aorta to superior vena cava fistula was identified. The patient underwent emergent surgery consisting of aortic root replacement with mechanical valveconduit and total arch replacement under hypothermic cardiopulmonary bypass. The patient had an uneventful postoperative recovery and was discharged at postoperative day 8. Postoperative CT aortic angiogram showed an excellent surgical result.