Management of a chronic Stanford type B dissection in a patient with a right-sided aortic arch.

We report the case of a 44-year-old male with a right-sided aortic arch who presented with dissection extending from his distal arch to his left common iliac artery. He was initially managed conservatively, but later became symptomatic with back pain; enlargement of the descending thoracic aorta was demonstrated on computed tomography scanning. He underwent staged repair of the aortic arch and descending thoracic aorta with the elephant trunk procedure - two operations one year apart, each time making a good postoperative recovery.