• Lin Xia, Zhonglu Yang, Yu Liu, Yuguang Ge, Lu Wang, and Hui Jiang.
• Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenhe District, Shenyang, China.
• Medicine (Baltimore). 2024 Feb 9; 103 (6): e37222e37222.

RationaleSyphilitic aortic aneurysm is a relatively rare type of cardiovascular syphilis. A small number of patients with syphilitic aortic aneurysms will be accompanied by aortic regurgitation and coronary stenosis. Apart from aortic rupture or dissection, syphilitic aortic aneurysm often causes associated vascular disorders, including left common carotid artery, innominate artery, and celiac artery stenosis or obstruction.Patient ConcernsIn this case, we observed left common carotid artery occlusion based on both ultrasound and intraoperative exploration. For patients with syphilitic aortic aneurysm, the first choice is still sufficient antibiotic therapy. The surgical indications include symptom relief and prevention of aortic rupture or sudden death.DiagnosesAortic valve insufficiency, aortic aneurysm, and syphilis.InterventionsAortic valve replacement, aneurysmectomy and total arch replacement combined with frozen elephant trunk implantation via single upper hemisternotomy approach.OutcomesThe patient did not suffer reventilation and reoperation. No transient or permanent neurological dysfunction was observed in this patient. And no acute renal failure occurred. The patient was discharged on 43 days after the operation.Lessons SubsectionsThe upper hemisternotomy has the advantages of faster postoperative recovery, shorter ventilation time, shorter intensive care unit stay, less blood transfusion, and less incisional pain compared with the full sternotomy, which is one of the reasons why we chose this procedure for this patient.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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