Abstract Background Treatment of complex aortic pathologies involving the transverse arch with extensive involvement of the descending aorta remains a surgical challenge. Since clamshell incision provides superior exposure of the entire thoracic aorta. we evaluated the use of this technique for single-stage total arch replacement by arch vessel reconstruction. Methods The arch-first t... https://countryscenesaddleryandpetsuppliers.shop/product-category/spur/