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When operating on a false aneurysm arising in the ascending aorta, protruding over the sternum, and eroding the sternum, the problems are how to approach the aneurysm and how to preserve the myocardium and the brain safely. In the present case, the operation was performed for the first time, to the best of our knowledge, safely by flipping up the eroded upper half of the sternum with separated clavicles and ribs, under a femoro-femoro (F-F) bypass and isolated brain perfusion.

New approach to the aneurysm originating in the ascending aorta, eroding the sternum and extending to the cervix.