Total aortic arch replacement in 2013: where do we go from here?

The author comments on the state of total aortic arch replacement surgery in 2013. According to the author, despite technological progress and development and exploration of hybrid procedures to manage the disorder, high stroke and operative mortality rates have been reported in centers worldwide. He believes that only sufficient data can provide the answer whether hybrid procedures are as good or better than open ones for total repair of the aortic arch.