[Brain protection on the aortic arch replacement--with deep hypothermic selective cerebral perfusion via right axillary artery].

Graft replacement was performed in the treatment of 31 patients with aneurysm involving the aortic arch from May, 1986 to December, 1992. Of the 31 patients, 16 had true aneurysm, 13 had aortic dissection and 2 had Annuloaortic ectasia. From May 1986 to May 1989, we did not have the policy about brain protection. Since June 1989, we performed the aortic arch surgery with deep hypothermic selective cerebral perfusion via right axillary artery and used open distal anastomosis technique. Besides, we exchanged the perfusion site to the ascending aorta when we finished the selective cerebral perfusion. In that way, brain complication rate was decreased from 57.1% to 11.7% and operative mortality was decreased from 85.7% to 29.1%.