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Two cases of dissecting aortic aneurysm with the right-sided aortic arch were reported. Aortography and chest CT demonstrated DeBakey IIIb dissecting aortic aneurysm in association with the right aortic arch and aberrant left subclavian artery arising from the diverticulum of Kommerell in two cases. In the first patient, a 47-year-old male, the intimal tear was repaired with patch grafting under the femoro-femoral bypass using centrifugal pump. Although the dissected lumen was completely closed with thrombus, paraplegia occurred and its recovery was unsatisfactory. In the second patient, a 53-year-old male, maintained on antihypertensive medication for one month, he expired at home 17 days after discharge. Since this type of dissecting aortic aneurysm is extremely rare, nine reported cases, including our two cases, are reviewed. Accurate diagnosis and careful surgical treatments of this disease are mandatory to obtain the satisfactory outcome.
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