Deep hypothermic circulatory arrest: real-life suspended animation

Deep hypothermic circulatory arrest (DHCA) is a cerebral protection technique that was developed in the 1950s and popularized in the 1970s. It has become one of the three most common cerebral protection techniques currently used in aortic arch surgeries, with the other two being antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP). At our institution, DHCA has been the cerebral protection technique of choice for over a quarter century. Our clinical experience with DHCA has been very positive, and our clinical studies have shown DHCA to have outcomes equal to (and sometimes better than) those of ACP and RCP, and DHCA to be very effective at preserving neurocognitive function. Other institutions, however, prefer ACP or RCP to DHCA. Each technique has its own set of pros and cons, and the question regarding which technique is the superior method for cerebral protection is hotly debated.