Operative technique
Our approach to aortic dissection repair has been previously described4,8. For both hemiarch and total arch repairs, we prefer axillary artery cannulation with antegrade cerebral perfusion with mild to moderate hypothermia depending on extent of anticipated repair. In general, we cool to 27°C for hemiarch repair and 24 to 22°C for total arch repair. The decision to proceed with hemiarch versus total arch is made based on presence or absence of aortic arch pathology (dissection with intimal tear, aneurysm, infection).