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Laparoscopic cyst unroofing and omentoplasty is a feasible surgical technique to treat primary splenic hydatidosis while preserving the spleen's immunologic function. Laparoscopic cyst unroofing and omentoplasty is a feasible surgical technique to treat primary splenic hydatidosis while preserving the spleen's immunologic function. We present a case of open surgical repair of an aortic arch pseudoaneurysm (AAP) without the use of hypothermic circulatory arrest in a patient with low ejection fraction and associated coronary artery diseas