Redo surgery for extensive chronic type A dissecting aneurysm following a Bentall operation

In the treatment of complicated aortic arch diseases especially in redo cases, appropriate strategies are mandatory to achieve optimal outcomes. In the extended aortic dissection without the reentry for visceral perfusion, a primary entry closure may lead to visceral ischemia. Modified long elephant trunk technique combined with fenestration technique may be one of the useful techniques to treat the complicated aortic dissection extending to the terminal aorta.