During imaging follow-up, the residual dissection after a type A repair dissection could progress and may require repair of the aortic arch and the distal aorta. Our approach for repairing the evolving dissection includes open aortic arch replacement involving all 3 supra-aortic branches in combination with the frozen elephant trunk (FET) technique (n = 14). Distal arch repair combines a vascular and endovascular treatment to treat aortic arch disease (n = 13). A 3D printed aorta model has been used preoperatively and intraoperatively to improve surgical results. Hereby we report our aortic arch surgical experience and results in the treatment for this challenging pathology.