Proximal aortic perfusion with passive cerebral flow: A method to prevent cerebral embolism in the arch and descending aortic operation

Antegrade aortic perfusion is preferable in arch and descending aortic oper ations. We describe a left lateral approach using an ascending aortic cannu la, temporarily relocated within the distal aorta to maintain hypothermic c ardiopulmonary bypass of the lower torso. This modification provides contin ual antegrade systemic perfusion and passive retrograde cerebral flow durin g arch repair. It minimizes the risk of embolization into the brachiocephal ic arteries of debris and malperfusion of the dissected aorta.