Aortotomy
With cardioplegia and ACP successfully established, aortic resection is performed to facilitate the introduction of the FET stent graft, and subsequently, the proximal aortic graft. In Z-2-FET, the aortic arch is fully resected from the sinotubular junction to the proximal Zone 3 border, and the descending thoracic aorta (DTA) is then examined via angioscope.14, 16 However, for Z-0-FET, an aortotomy is usually performed up to 15 mm distal to the sinotubular junction and 10-20 mm proximal to the origin of the brachiocephalic trunk, allowing the removal of a significant portion of the ascending aorta. Subsequently, both Yamamoto et al. and Jakob et al.reapproximate the walls of the remaining proximal ascending aorta with surgical glue and staying sutures.16, 17 Aortic valve resuspensions can also be performed to preserve valve function.17