Facilitated surgical strategy in total arch replacement and descending aorta stent grafting with the E-vita open hybrid prosthesis.

The patient is a 69-year-old male with a symptomatic, fusiform distal arch/proximal descending aortic aneurysm extending over 9 cm in length. As demonstrated in the CTscan, the distal arch aneurysm is 5.5 cm diameter with a newly detected symptomatic ventral sac extending to 6 cm in diameter, presenting as a penetrating aortic ulcer (PAU). The ascending aorta is ectatic to 4.5 cm. His risk factors include arterial hypertension and a stroke in 1994 without residual effects.