Thoracic endovascular aortic repair (TEVAR) is an established treatment option, although some anatomical challenges require a through-and-through wire technique, and subsequently transapical access via minithoracotomy can be required. It is clear that an objective tool to facilitate decision-making is needed. A 3D print of a severely angulated aortic arch was used as a template to advance a stent graft, and this was achieved after pulling the top of the wire. This simulation assisted in decision-making relating to transapical access with a wire externalization. A 3D aortic print could be used in advance to simulate the TEVAR procedure and facilitate any other decisions regarding additional transapical access.
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