Photo 2.

Bench test and graft modification. A – Sharp angulation of the ascending aorta after previous surgery. Blue arrow shows the direction of the tip of the stent graft towards the pseudoaneurysm. B – Mobility (red arrow) of the soft Terumo guidewire inside the ring of the artificial aortic valve. C – Steering of the position of the wire by the 12 F vascular port (working as a lever – red arrow) from the apex (working as the fulcrum of the lever – blue arrows). D – Schedule for the procedure. E – Stent graft modification (blue arrow shows the position of the left subclavian artery (LSA) fenestration, red arrows indicate double longitudinal ties). F – Further stent graft modification with pre-cannulation of the LSA fenestration (yellow arrow), shortening of the tip of the introduction system (green arrow), position of the LSA fenestration (blue arrow)