Anteroaxillary thoracotomy facilitates the use of retrograde cerebral perfusion in distal aortic arch reconstruction.

Anteroaxillary thoracotomy in a 45-degree position provides an ideal view of the distal aortic arch and also makes direct superior vena caval cannulation possible for retrograde cerebral perfusion. This approach is especially useful in cases in which retrograde cerebral perfusion is indicated as an adjunct to deep hypothermic circulatory arrest in repair of the distal aortic arch.