Repair of an acute dissecting aneurysm of the ascending aorta and arch presents a technical challenge to the cardiac surgeon. The dissected tissues in the aorta are friable and bleeding from suture holes and may be difficult to control. Moreover, when the dissection extends into the aortic valve annulus, the commissures of the valve may be detached leading to valvular imcompetence. Dissection into the arch and brachiocephalic branches may require extensive repair and arch replacement with a vascular graft.