A 74-year-old woman underwent ascending aortic replacement due to acute type A dissection 2 years previously. She received total aortic arch replacement with open stent grafting of the descending thoracic aorta for enlargement of the residual aortic dissection in the aortic arch and descending thoracic aorta. Operative method and, intra- and post-operative protective method of spinal cord are reported and discussed.
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