We read with great interest the article by Abe and colleagues1 about aortocar-otid bypass surgery for malperfused left carotid artery complicated by acute aortic dissection. Their patient was a 57-year-old man brought to the hospital with right hemiparesis and loss of consciousness. Computed tomography of the chest showed acute type A aortic dissection, and the left carotid artery was occluded by a thrombosed false lumen. First, they performed the ringed graft anastomosis to the left common carotid artery. Then, this patient underwent ascending aorta replacement under hypothermic circulatory arrest and selective cerebral perfusion. After that, the ringed graft was anastomosed to prosthetic graft. The patient recovered well without any neurologic deficit.
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