Aneurysm of Brachiocephalic Artery and Ascending Aorta

A 40 years old male with complains of blood in vomitus, bloody sputum and chest pain with X-ray chest suggestive of widened mediastinum. Computed tomography scan indicated saccular aneurysm at the origin of brachiocephalic artery with fusiform aneurysmal dilatation of ascending aorta and compression of superior vena cava (SVC). The surgery performed was ascending aortic aneurysm repair with interposition graft while excising diseased segment of brachiocephalic trunk and placing an interposition graft for the same, relocating it on neo aorta and ligation of fistulous connection. Post-operative there were no hematemesis and hemoptysis. Brachiocephalic artery aneurysm is uncommon and that though with aneurysmal dilatation of aorta is rarely reported.