Operative technique
Our approach to aortic dissection repair has been previously
described4,8. For both hemiarch and total arch
repairs, we prefer axillary artery cannulation with antegrade cerebral
perfusion with mild to moderate hypothermia depending on extent of
anticipated repair. In general, we cool to 27°C for hemiarch repair and
24 to 22°C for total arch repair. The decision to proceed with hemiarch
versus total arch is made based on presence or absence of aortic arch
pathology (dissection with intimal tear, aneurysm, infection).