Pericardial fat pads have been successfully used for many years by thoracic and cardiac surgeons for a number of applications. We recently used a pedicled and well-vascularized pericardial fat pad in a patient who underwent replacement of a distal aortic arch aneurysm with a Dacron tube graft, in order to avoid contact between the anastomoses and the oesophagus in an effort to reduce the risk of subsequent infection and fistula formation. This simple technique may provide a source of vital tissue that may be useful for protecting anastomoses after thoracic aortic surgery, particularly in cases requiring re-operation. To our knowledge the use of pericardial fat pads has not been previously reported in the English literature for this purpose.