In this issue of the JEVT, Joseph and colleagues1 describe a transseptal through-and-through wire technique to facilitate stent-graft passage through a large aortic arch aneu-rysm. The technique described consists of a series of procedural steps to establish a transseptally placed sheath in the ascending aorta to get an antegrade grip with a snare on the tip of the stiff transfemoral guidewire used for stent-graft delivery. This trick allowed the operators to maneuver a stent-graft component into the desired sealing zone of the ascending aorta and complete a complex total arch chimney repair.
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