It is presented the case of acute type II aortic dissection in a patient wi
th aneurysmal ascending aorta, hypoplastic arch and isthmic coarctation. On
e single step replacement of the ascending aorta, arch and the isthmus was
performed by ensuring simultaneous optimal perfusion above and below the co
arctation through the femoral and subclavian artery. (C) 1999 Elsevier Scie
nce B.V. All rights reserved.