• Maoxun Huang, Hulin Piao, Bo Li, Yong Wang, Tiance Wang, Zhicheng Zhu, Dan Li, and Kexiang Liu.
• Department of Cardiovascular Surgery, Second Hospital of Jilin University, Changchun, Jilin, China.
• Medicine (Baltimore). 2019 Mar 1; 98 (11): e14727e14727.

RationaleAn aberrant right subclavian artery (ARSA), arising from the proximal descending aorta, is a common aortic arch anomaly, with an incidence of 0.5% to 2%. However, coexistence of dissection and an ARSA is extremely rare. We presented the first case of successful management of complicated Stanford B-type aortic dissection combined with an ARSA with a new inclusion technique and stent graft (SG) implantation through an upper partial sternotomy.Patient ConcernsA 39-year-old woman with a history of severe hypertension was admitted to our hospital because of sudden-onset chest and upper back pain.DiagnosesAortic computed tomography angiography (CTA) demonstrated complicated Stanford B-type dissection with ARSA.InterventionsA new inclusion technique and SG implantation through an upper partial sternotomy were performed for the patient, whose aortic arch branch vessels, including ARSA, were fully preserved.OutcomesThe patient had an uneventful postoperative course without neurologic deficits, and no blood transfusion was required during the hospitalization. The false lumen completely disappeared on postoperative CTA.LessonsThis new inclusion technique through an upper partial sternotomy is a safe and feasible treatment for complicated Stanford B-type aortic dissection with an ARSA with the primary tear located in the aortic arch.

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