Abstract
The optimum management strategy of cerebral malperfusion (CM) in type A aortic dissection (TAAD) has been undefined and controversial despite numerous advances in the past decades. Many surgeons avoid such patients for fear of cerebral bleeding secondary to hypothermic cardiopulmonary bypass and out of the concern that the neurologic deficit would persist postoperatively, leading to mortality and debilitating complications. In this regard, the study by Fukuhara and colleagues1 in this issue of The Annals of Thoracic Surgery represents an important step toward unraveling the mysteries of CM in TAAD and improving our knowledge about this special subset of patients.
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