Keywords: POISE-2 study; VISION study; antegrade cerebral perfusion; aortic arch; aspirin; atrial fibrillation; bleeding; clonidine; dabigatran; factor Xa inhibitors; guidelines; hybrid aortic arch repair; left atrial appendage occlusion; moderate hypothermic circulatory arrest; myocardial injury after noncardiac surgery; paradigm shifts; perioperative cardiovascular evaluation; risks scores; stroke; surgical ablation; troponins.