Introduction
Open elective and non-elective aortic surgery have proven track record in reducing mortality related intimal aortic disruption, however and despite timely and specialized aortic surgical interventions, mortality and morbidity remain inconsistent and wavering on multiple factors. Amongst, the use of cardiopulmonary bypass and hypothermic circulatory arrest are associated with coagulation related adverse events.1 Moreover, coagulopathy is related to urgency or setting of the operation. Nonetheless, studies also correlated coagulopathy to type of pathology, urgency, predictors implicating bleeding intraoperatively and post-operatively. However, no robust evidence exists to implicate utilization of aortic arch device technologies in the causation of coagulopathy and the correlation to performance, applicability, and type of frozen elephant trunk use. To this end, and given the rapid surge of device technologies application and use in aortic arch surgery, we sought to explore the development of coagulopathy and correlate this to type of FET highlighting potential predictors to help aid clinical decision making and framework.