Extensive total arch replacement via clamshell incision in a patient with aortic arch aneurysm and Stanford type B aortic dissection.

The utility of the clamshell approach, namely, a bilateral anterior thoracotomy incision for treating extensive thoracic aortic disease was described by Kouchoukos et al. in 2001 and by Doss et al. in 2003. We describe the utility of this approach for treating aortic arch aneurysm with Stanford type B aortic dissection.