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A Case of Replacement of the Chronic Dissecting Descending Aortic Aneurysm after the Frozen Elephant Trunk Technique Masahiro Inagaki, Toshiya Tokui, Yasumi Maze, Kouji Hirono and Taro Fujii(Department of Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Japan) A-54-year-old man with an extensive dissecting thoracic aortic aneurysm underwent staged surgery which consisted of preceding total aortic arch replacement with the frozen elephant trunk technique using J Graft Open Stent Graft, followed by open descending aorta repair. During the second operation, a Dacron graft was anastomosed directly to the stent graft and the true lumen thus, the true lumen could be preserved around the stent graft. We herein discuss our approach in this case, focusing on prevention of bleeding from the elephant trunk. Jpn. J. Cardiovasc. Surg. 46 : 316-319(2017)