Operative management of acute aortic arch dissection using profound hypothermia and circulatory arrest

Six consecutive patients with acute aortic dissection involving the transverse aortic arch underwent surgical repair using profound hypothermia and circulatory arrest. All patients survived without neurological deficit. Postoperative angiographic evaluation has revealed complete resection or obliteration of patent false lumen within the aortic arch and ascending aorta in all patients. Use of this adjunct in the operative management of aortic arch dissection has allowed bloodless inspection and repair of extensive intimal tears, complete intimal adventitial reapproximation or resection, avoidance of clamp injury to fragile dissected aortic tissue, and assurance of patent arch-cerebral revascularization.