Pii: S1010-7940(01)00657-1

Deep hypothermic circulatory arrest (DHCA) has been used routinely for surgery involving the aortic arch. Recently, techniques have been developed that avoid circulatory arrest and maintain low̄ow cerebral perfusion (LFCP) in an attempt to avoid the potential neurological sequelae associated with DHCA. We describe a technique of LFCP that avoids circulatory arrest and direct cannulation of the arch vessels. Five patients underwent reconstruction of the aortic arch with concomitant biventricular intracardiac repair. The distal ascending aorta was cannulated and patients were systemically cooled. The cannula was advanced into the innominate artery and snared in place prior to opening and reconstructing the aorta with continuous LFCP. In all ®ve patients, we completely avoided circulatory arrest and direct cannulation of the arch vessels. All patients survived and there were no adverse neurological outcomes. q 2001 Elsevier Science B.V. All rights reserved.