Thoracic aortic lesions, especially Stanford type A aortic additions, are among the most deadly cardiovascular diseases today. Relying on the comprehensive advantages of Peking Union Medical College Hospital, the Department of Cardiac Surgery of Peking Union Medical College Hospital has completed 40 difficult thoracic aortic surgeries in the eight years from 2002 to 2009, and the procedures used cover almost all of the currently commonly used international surgical procedures for treating aortic root lesions, and have created a record of zero deaths. There are two general categories of patients undergoing surgery on the thoracic aorta. One category is elderly hypertensive patients with dilated aortic aneurysms that rupture and produce aortic additions. These patients require prophylactic elective surgery, including replacement of the ascending aorta, aortic arch, and cerebral vessels, as well as distal artery stenting in some patients. The second category is acute attacks such as Marfan’s syndrome. The latter is the majority of our cases. The 40 thoracic aortic procedures performed included 20 total aortic arch replacements and descending aortic elephant trunk procedures, 10 Bentall’s procedures, and 10 Stanford type B entrapment peritoneal stenting procedures. There were no serious complications such as spinal cord injury after surgery, and the long-term results were good. Director Miao Qi of the Department of Cardiac Surgery said that the rich exposure to disease types, skilled surgical operations, mature management of extracorporeal circulation and multidisciplinary collaboration in tackling the problem are the important foundation for the 40 cases of zero death in thoracic aortic surgery in our hospital. Relying on the comprehensive advantages of Concordia, the thoracic aortic diseases that come to our hospital are often complex, often involving the aortic sinus, ascending aorta, aortic arch and thoracic descending aorta. Therefore, the surgical approach we adopt covers almost all the surgical procedures that are currently used internationally to treat aortic root lesions. Long-term practice has trained a surgical team that is mature in the management of extracorporeal circulation, skilled in intubation of special sites, conversion of multiple diversion methods, and intraoperative brain protection. The cooperation of anesthesiology, surgery, internal medicine, ICU and other departments in overcoming difficulties has made us adept at handling complex situations and making the characteristics of a large general hospital in the treatment of thoracic aortic surgery. Professor Miao Qi also pointed out that the introduction and practice of the concept of staged surgery and the development of minimally invasive techniques such as stent placement are other reasons for improving the outcome of surgery for thoracic aortic disease. Patients with thoracic aortic disease are often already in critical condition when they are brought to the hospital and can hardly withstand oversized surgery. If the surgeon replaces all the vessels in one major operation, the operation is successful, but the patient dies due to excessive bleeding. Some surgeries in the United States have now been staged. Prof. Miao Qi suggests that Chinese doctors and patients can change their mindset and choose staged surgery from the perspective of patient safety. Large vessel surgery is very challenging because it involves the heart, head and neck arteries, and the whole cardiovascular system, and the surgery requires not only cardiac arrest, but even circulatory arrest. These reasons contribute to the high mortality rate of patients undergoing major vascular surgery. As medical technology and techniques have improved, stenting has replaced traditional aortic replacement and has also greatly reduced the risk of the procedure.