Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 14 2 2019 03 14 81 84 EN Anjith Rajakumar Department of Cardiac Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Tamil Nadu, India. Mithun Ravikumar Department of Cardiac Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Tamil Nadu, India. Karthik Raman Department of Cardiac Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Tamil Nadu, India. Arun Singh Department of Cardiac Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Tamil Nadu, India. Ejaz Sheriff Department of Cardiac Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Tamil Nadu, India. Rajan Sethuratnam Department of Cardiac Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Tamil Nadu, India. 2018 04 14 2018 12 05 We report a case of a type B aortic dissection with an aneurysm treated by the replacement of the proximal descending thoracic aorta via the reversed elephant trunk technique. A 48-year-old asymptomatic man was diagnosed with a type B aortic dissection, moderate aortic regurgitation, and a good biventricular function in March 2012. Four years later (April 2016), a contrast-enhanced computed tomography examination revealed an aneurysmal dilatation in the patient’s descending thoracic aorta with a thrombosis in the proximal part of the false lumen, which warranted surgical repair. He underwent type B aortic dissection repair through the left posterolateral thoracotomy. Three months after the surgery, the patient developed a type A aortic dissection with severe aortic regurgitation, which was successfully managed via a Bentall procedure with arch replacement facilitated by the reversed elephant trunk technique performed during the initial surgery through thoracotomy. At 2 years follow-up, the patient was doing well with a normal left ventricular function.   https://rhythm.tums.ac.ir/index.php/jthc/article/view/868 https://rhythm.tums.ac.ir/index.php/jthc/article/download/868/836