{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T17:14:01Z","timestamp":1779383641327,"version":"3.53.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>An ascending aortic aneurysm is defined as dilatation of the ascending aorta to \u22651.5 times its normal diameter. Surgical intervention is recommended when the diameter exceeds 55\u2005mm to prevent life-threatening complications such as rupture or dissection. Persistent fifth aortic arch is a rare congenital vascular anomaly, which may present as a dual-lumen aortic configuration and can mimic acquired pathological conditions such as aortic dissection or aneurysm, posing a diagnostic challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 39-year-old male with long-standing hypertension presented with cough and shortness of breath. Initial computed tomography (CT) performed to exclude pulmonary embolism incidentally revealed a markedly dilated ascending aorta. Following intensive care unit admission and stabilization, echocardiography and CT aortography demonstrated severe aortic regurgitation and a giant ascending aortic aneurysm measuring 10.5\u2005cm with dual-lumen morphology interpreted radiologically as Stanford type A aortic dissection. The patient underwent urgent Bentall procedure. Histopathological examination confirmed a dual-lumen vascular structure consistent with persistent fifth aortic arch, establishing the congenital aetiology. The patient recovered uneventfully and remained asymptomatic during cardiothoracic follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the diagnostic challenge of distinguishing congenital persistent fifth aortic arch from acquired aortic dissection in the setting of a giant ascending aneurysm. Despite radiologic ambiguity, prompt surgical repair was definitive. Histopathological confirmation provided etiologic clarity and contributes to understanding the natural history of this rare anomaly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag330","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T11:22:04Z","timestamp":1778498524000},"source":"Crossref","is-referenced-by-count":0,"title":["Case report: persistent fifth aortic arch presenting as a giant ascending aortic aneurysm: diagnostic challenge and surgical resolution with Bentall procedure"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7820-7528","authenticated-orcid":false,"given":"Abdelrahman Waleed Alsayed","family":"Manaa","sequence":"first","affiliation":[{"name":"Cardiac Surgery Department, International Medical Center (IMC) , PO Box 2172, Jeddah 21451 ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mokhtar","family":"Kahin","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, International Medical Center (IMC) , PO Box 2172, Jeddah 21451 ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukhtar","family":"Metwally","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, International Medical Center (IMC) , PO Box 2172, Jeddah 21451 ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafat","family":"Abu Shakra","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine Department, International Medical Center (IMC) , PO Box 2172, Jeddah 21451 ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Abu Khudair","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, International Medical Center (IMC) , PO Box 2172, Jeddah 21451 ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"2026052112173907000_ytag330-B1","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1161\/CIR.0000000000001106","article-title":"2022 ACC\/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association\/American College of Cardiology joint committee on clinical practice guidelines","volume":"146","author":"Isselbacher","year":"2022","journal-title":"Circulation"},{"key":"2026052112173907000_ytag330-B2","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.1016\/j.athoracsur.2015.10.090","article-title":"Bentall procedure: a systematic review and meta-analysis","volume":"101","author":"Mookhoek","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2026052112173907000_ytag330-B3","doi-asserted-by":"crossref","first-page":"S64","DOI":"10.1016\/j.jtcvs.2010.07.033","article-title":"The Bentall procedure: is it the gold standard? 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