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Background: Due to its high mortality and morbidity rates, the surgical treatment for ruptured aortic arch aneurysms is challenging. There is no consensus on the optimal treatment modality in this patient group. Herein, we present a case of a ruptured giant atherosclerotic aortic arch aneurysm treated successfully with emergency surgical intervention.Case Report: A 74-year-old female patient was admitted to our emergency clinic with complaints of blurred consciousness, chest pain, and dyspnea. In physical examination arterial blood pressure, pulse, oxygen saturation was 80/40 mmHg, 122 beats/min, 85-90% respectively. In oscultation of left hemithorax breath sounds was decreased. Chest X-ray revealed a giant aortic aneurysm and opacity at left hemithorax which was suggestive of pleural effusion. A ruptured saccular aortic arch aneurysm with a size of 8x6 cm2 was detected in the contrasted tomography. Emergency surgery with right selective antergrade cerebral perfusion performed uneventfully. Because of pulmonary complications she wasnÂ’t tolerate extubation and re-intubated. After appropriate therapy in anesthesiology and reanimation clinic she was discharged in the postoperative 15th day. Conclusion: Recent outcomes of open arch repair and hybrid TEVAR demonstrate acceptable results, particularly early after the procedure, open arch repair provides more reliable outcomes during follow-up. These two surgical strategies, when properly selected according to the individual risk, can improve the surgical outcomes in patients with aortic arch aneurysms

Successful surgical treatment of a ruptured giant atherosclerotic aneurysm of arcus aorta