CONCLUSION
The advantages of FET procedures over cET procedures, and that of Z-2-FET over Z-3-FET are widely reported and well-documented.1, 5 It is clear that Z-2-FET currently represents an efficacious, robust approach to treating Type A AAD and other structural aortic arch pathologies. Indeed, recent data from novel trials investigating Z-0-FET are promising and seem to suggest that proximalisation of the distal anastomosis not only improves surgical access (thereby shortening CPB, ACP, and HCA time) but also is associated with improved mortality rates and lower incidence of SCI, cerebral injury, RLN injury, renal injury, and visceral ischaemia.16, 17, 18 This said, it should be recalled that efficacy of Z-0-FET in terms of FL obliteration and postoperative TL integrity is varied.16 Therefore, larger scale investigations comparing both approaches and their respective techniques and complications would shed light and help determine whether proximalisation of aortic repair from Zone 2 to Zone 0 is simply concept, or a true challenge that represents the next step forward in aortic repair.