Fig. 3

The graft inversion technique of distal anastomosis: a A 4-branched prosthetic graft cut to an appropriate length. b and c Careful inversion of the graft using forceps. d Forward insertion of the inverted graft into the true lumen of the descending aorta. e Distal anastomosis is performed using 4–0 polypropylene horizontal mattress sutures and lined with Dacron®. f The inverted graft was pulled up proximally after distal anastomosis was completed