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We read with great interest the case presentation by Kaskar et al in the current issue of the World Journal for Pediatric and Congenital Heart Surgery.1 The authors describe two cases of patients with right circumflex aorta and symptoms resulting from tracheoesophageal compression. They were both treated with the aortic uncrossing procedure, as described by Planché and Lacour-Gayet.2 The authors are to be congratulated on the successful management of these two cases. It is particularly important to highlight that the aortic uncrossing procedure provides complete relief of the vascular ring as opposed to sole division of the ligamentum arteriosum. Therefore, the aortic uncrossing procedure, despite being a complex procedure should be the therapy of choice in symptomatic patients with circumflex aorta.3 Concerning the perfusion strategy, we think, the deep hypothermic circulatory arrest, as used by the authors, can usually be replaced by more physiologic perfusion strategies during the aortic uncrossing procedure.