Kyobu geka. The Japanese journal of thoracic surgery
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One hundred eighty two patients with thoracic aortic aneurysms or dissections who required total arch replacement (TAR) were operated on with separated graft technique and selective cerebral perfusion (SCP) between 1991 and 2000. These patients were divided into 4 groups according to the pathology as follows: group 1; acute type A dissection, group 2; chronic type A dissection, group 3; distal arch aneurysm and group 4; proximal arch aneurysm. For SCP, both the innominate artery and the left common carotid artery were cannulated when the patient was cooled to a rectal temperature of 22 degrees C. ⋯ Permanent neurological complication occurred in 3% in group 1 and 8% in group 3. Hospital mortality was affected by the type of aneurysms and dissections. It is necessary to give careful consideration to the indication of TAR with SCP, especially in acute type A dissection and distal arch aneurysm.