Total Aortic Arch Replacement + Coronary Artery Bypass: Cardiothoracic Surgery Completes Difficult Surgery Patient Yin xx (hospitalization number 893904) was admitted to Ward 4 of Cardiothoracic Surgery Department of Xiangya Hospital in an emergency due to sudden severe pain in the thoracic back, and was diagnosed as acute aortic coarctation aneurysm (type A). The operation took 7 hours and was completed successfully. The patient recovered satisfactorily after the operation and was discharged from the hospital recently. Acute aortic coarctation aneurysm is a type of disease with rapid onset, seriousness and development, and most of them rupture and die within a short period of time. Surgery is the only treatment method. Due to the special location of the aortic arch, this surgery needs to be performed under deep hypothermia (the lowest temperature of the whole body is lowered to 16℃) and total stoppage of circulation, so not only the surgery itself is complicated, but also various organs of the whole body are affected to different degrees, and cardiothoracic surgery has routinely performed this kind of surgery in recent years; however, this patient’s ascending aortic dissection has affected the opening of the right coronary artery, so in addition to using a membrane stent to However, this patient’s ascending aortic dissection had affected the opening of the right coronary artery. In the operation, in addition to closing the distal entrapment lesion by placing a stent with membrane into the descending aorta, a four-branch artificial vessel was used to replace the whole aortic arch (including three head and arm trunk vessels), and a 6 mm Gortex vessel was used to bridge with the right coronary artery, and the whole operation took more than 7 hours.