Background-Aortic arch surgery has a high incidence of brain injury. This may in part be caused by a cerebral metabolic deficit observed after hypothermic circulatory arrest (HCA). We hypothesized that selective antegrade cerebral perfusion (SACP) would attenuate this phenomenon. Methods and Results-In a prospective randomized trial, 42 adult patients were allocated to either HCA (22)

If brain venous outflow Tdegrees (JB) accurately reflects brain Tdegrees, NP Tdegrees is a safe surrogate indicator of cooling. During rewarming, all peripheral sites underestimate brain temperature and caution is required to avoid hyperthermic arterial inflow, which may inadvertently, result in brain hyperthermia.

Differential temperature management using the Cobra aortic catheter is possible. Further studies are necessary to establish whether the hypothesized advantages of combining corporeal normothermia with brain hypothermia can be realised.