Upper Partial Sternotomy Combined With Left Anterior Thoracotomy for Acute Type A Aortic Dissection With Severe Pectus Excavatum: A Case Report

We report a case of acute type A aortic dissection (ATAAD) complicated by severe pectus excavatum in a 55year-old woman.Preoperative computed tomography demonstrated severe leftward displacement of the heart, suggesting that standard median sternotomy would not provide adequate exposure.Therefore, an upper partial sternotomy combined with left anterior thoracotomy was selected.This approach permitted ascending aortic replacement with adequate surgical exposure.The patient was discharged home, ambulatory, on postoperative day 35.This case suggests the feasibility of this surgical approach for overcoming anatomical constraints in emergency cases involving severe pectus excavatum.