Distal aortic perfusion during aortic arch reconstruction: another tool for the aortic surgeon.

Complex aortic arch reconstruction remains one of the greatest challenges facing cardiothoracic surgeons today. Deep hypothermic circulatory arrest is the most common technique for open arch replacement. Either antegrade or retrograde cerebral perfusion is often utilized in an attempt to decrease neurologic complications. In addition to cerebral perfusion, we have employed continuous perfusion of the thoracic aorta to minimize spinal cord, visceral, and lower extremity ischemia. This approach does not significantly increase the complexity of the operative procedure while reducing the ischemic time of critical areas, which may lead to improved patient outcomes.