Aortic Arch Replacement with Moderate Hypothermia and a Modified Three-PUMP Circuit

A strategy employing moderate hypothermia for the replacement of the aortic arch is proposed to avoid the complications of profound hypothermic circulatory arrest. Two patients underwent the complete replacement of the aortic arch using three pumps - for the brain, thoracoabdominal aorta, and heart, respectively. There were no complications and the patients were extubated uneventfully. The method preserved the auto-regulation of the cerebral blood flow without high vascular resistance.