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The patient underwent a three-stage-procedure including aortic arch debranching, thoracic endovascular aortic repair of the ascending aorta, aortic arch and descending thoracic aorta, and direct aortic valve-in-valve replacement using transcatheter heart valve. The details of the procedures are described with a discussion of the challenges and the decision-making process.<\/jats:p>","DOI":"10.1055\/s-0043-1764299","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:22:33Z","timestamp":1679358153000},"page":"e17-e20","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid Thoracic Aortic Repair and Aortic Valve-In-Valve Replacement for Chronic Type A Dissection"],"prefix":"10.1055","volume":"12","author":[{"given":"Turki B.","family":"Albacker","sequence":"additional","affiliation":[{"name":"Cardiac Sciences Department, King Saud University College of Medicine, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faisal K.","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Cardiac Sciences Department, King Saud University College of Medicine, Riyadh, Saudi 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