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Total arch replacement( TAR) is used to be a complicated and quite invasive aortic procedure. To perform TAR safely and effectively under all circumstances, we have constructed standardization of the procedures of TAR. The aim of this study is to analyze the impact of surgeons' experience on surgical outcome of TAR to evaluate our standardization. From January 2008 to December 2020, 346 consecutive patients (mean age 73.6±10.2) underwent elective TAR through a median sternotomy at our institute. TAR was performed by three types of surge