摘要To the Editor:Aberrant right subclavian artery (ARSA) is a congenital vascular anomaly.Stanford-type A aortic dissection with ARSA is rare.We reported a strategy that involved the use of a four-branch prosthetic graft to reconstruct the four supra-arch branch vessels for a Stanford type A aortic dissection with ARSA.A 46-year-old male was admitted to Beijing Anzhen Hospital because of sudden chest pain.Type A aortic dissection and ARSA were found from the computed tomography (CT) scan.Emergent procedure was planned.The right axillary artery was prepared for aorta cannulation,and subsequently,median stemotomy was performed.The aortic valve was normal.The ascending aorta was replaced during systemic cooling.When the nasal temperature reached 20℃,the left subclavian artery (LSCA) and bilateral common carotid arteries were clamped,and the right axillary artery perfusion was stopped.The aortic arch was cut open,and unilateral antegrade cerebral perfusion was performed through the right common carotid artery with another aorta cannulation.