Background: Retrosternal gastric tube reconstruction is a common surgical technique for managing esophageal cancer, but it complicates acute type A aortic dissection repair and raises concerns about gastric tube damage.
Case presentation: A 73-year-old female, who underwent esophagectomy with retrosternal gastric tube reconstruction 6 months ago for esophageal cancer, presented with severe chest pain. Acute type A aortic dissection was confirmed by contrast-enhanced computed tomography, and emergency hemiarch replacement through a median sternotomy was performed, preserving the gastric tube without injury. The patient recovered well and was discharged after 3 weeks, showing no gastrointestinal symptoms or signs of mediastinitis.
Keywords: Esophageal cancer; acute type A aortic dissection; hemiarch replacement; median sternotomy; retrosternal gastric tube reconstruction.