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Introduction for Volume 27 Issue 3

        In this issue we have an excellent report by Malakh Shrestra and colleagues on total arch replacement with a 4 branched Frozen elephant trunk (FET) graft in acute Type I aortic dissection. This experience group in Hannover over the years have master this technique and, in this issue, we are very delighted to follow step by step their technique of total arch replacement with the FET technique. With their tips, the authors advocate that with the use of their technique, they provide continuous myocardial perfusion during complex arch surgery, allowing arch procedure in elderly and high-risk individuals.
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