This videotape depicts graft replacement of the entire aorta in two stages. In the first stage, the ascending aorta is replaced by a graft using the elephant trunk technique, in which a segment of graft is left remaining hanging down into the descending thoracic aorta, to which a graft is attached at a later date when a thorocoabdominal aortic replacement is done at a second operation, replacing the descending thoracic and abdominal aorta.