Abstract
A critical consideration in the operative strategy for aortic arch replacement, how best to protect the brain while providing surgical access to the cerebral vessels, involves two key aspects: minimizing cerebral ischaemia and preventing cerebral embolization of air and atheromatous debris. We describe a technique, using a trifurcated branched graft, that combines hypothermic circulatory arrest, selective antegrade perfusion and axillary artery cannulation.
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