Rupture of an aortic arch aneurysm is a life-threatening emergency with the risk of mortality escalating by the hour. We describe the successful hybrid repair of a ruptured bovine aortic arch aneurysm in a 75-year-old man, which involved aortic arch debranching by ascending aorta-bicarotid bypass followed by relining of the aortic lumen with a stent-graft. The procedure was not only lifesaving but also resulted in an active gentleman at 2-year follow-up. Considering the morbidity and mortality of open surgery using circulatory arrest, state-of-the-art synchronous hybrid repair seems to be an effective alternative for ruptured aortic arch aneurysms.
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