Management of aortic arch aneurysm using profound hypothermia and circulatory arrest

The cases of 9 patients with aneurysms involving the aortic arch, repaired under profound hypothermia (average, 15.5 degrees C) and circulatory arrest, are presented. Five patients underwent elective operation and 4, emergency operation. Arch resection and graft replacement were done in 7 patients. Two patients with infected pseudoaneurysms of the aortic arch received patch grafts. There were 2 deaths (22%) from coagulopathy and decerebration. Seven patients are alive and well 18 to 45 months following repair. The combination of profound hypothermia and circulatory arrest appears to be a promising solution to a difficult problem.