Case Report
A previously healthy 61-year-old male was referred to our hospital for sudden chest pain. Chest computed tomography (CT) revealed ATAAD. We performed emergency total arch replacement for ATAAD using the elephant trunk technique under cardiopulmonary bypass and ante-grade selective cerebral perfusion (Figure 1a and b). The patient was extubated on postoperative day 1 and started the rehabilitation. However, he collapsed with right hemiplegia on postoperative day 5. We performed three-dimensional cerebral CT that revealed occlusion of the left anterior cerebral artery (Figure 2) . Cerebral thrombectomy was performed by cerebral interventionalists. Pathology reports revealed a yellowish material that was collected with the fresh thrombus to be consistent with BioGlue (Figure 3 a and b).