Combining Cerebral Perfusion With Retrograde Inferior Vena Caval Perfusion for Aortic Arch Surgery.

Hypothermic circulatory arrest and selective cerebral perfusion are standard procedures during total arch replacement to treat acute type A aortic dissection. However, organ ischemia during anastomosis between the graft and descending aorta contribute to high risk of mortality and morbidity. Here we describe the combination of antegrade cerebral perfusion and retrograde inferior vena caval perfusion as a way to ensure continual perfusion of the brain, abdominal viscera, and spinal cord during anastomosis and thereby improve outcomes of total arch replacement.