Aortic arch debranching procedure was conducted on a patient who had previously had valve sparing aortic root replacement (David) and hemiarch replacement procedures at another center and was referred to Erfan Niayesh Hospital with dissecting thoracic and arch aortic aneurysms. Dr. Frouzannia performed the surgery at Erfan Niayesh Hospital, and Dr. Fallah also conducted the echocardiographic evaluation.