[Aortic arch and descending aortic replacement under deep hypothermia and circulatory arrest through left...

Graft replacement of the transverse aortic arch and the descending thoracic aorta was done for two cases with Stanford type B aortic dissection involving the aortic arch. Cardiopulmonary bypass was established with left atrium and femoral vein for venous line and femoral artery for arterial line. Patients were cooled until their EEG activity had disappeared, then the bypass was discontinued. Lesser curvature of the transverse aortic arch was resected and graft was sutured by beveled fashion. After reinstitution of the bypass, intercostal arteries (Th8-10) were reattached to the graft and distal anastomosis was made above the diaphragma. Postoperative recovery was uneventful in both cases.