Resection of ascending aorta aneurysm in redo surgery through an anterior thoracotomy

Resection of an aneurysm of the distal ascending aorta was performed under hypothermic circulatory arrest and retrograde cerebral perfusion though a right anterior thoracotomy. Seven years before, the patient had undergone orthotopic cardiac transplantation and had required pectoral muscle plasty to heal an infectious mediastinitis. This new approach avoided a potentially hazardous sternotomy and allowed successful resection of the aneurysm and reconstruction of a thrombosed innominate vein.