"Sandwich" Frozen Elephant Trunk and Left Axillary Cannulation Facilitates Repair of Ruptured Aortic Arch and Descending Aorta

The authors present the surgical management of an emergent, ruptured, chronically dissected aortic arch aneurysm. The surgical reconstruction was facilitated by the use of left axillary artery cannulation, the utilization of total arch replacement, and a "sandwich" frozen elephant trunk technique utilizing two thoracic aortic stent grafts to obtain hemostasis.