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The midterm results show satisfactory hemodynamic performance and clinical improvement. Valve competence and reoperation rates are comparable with those of other reports. Durability of the mural annulus shortening suture procedure for mitral valve repair is questioned because progressive annular redilatation occurs.

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Using unilateral antegrade cerebral perfusion in a pressure-controlled manner during mild systemic hypothermia is a safe protection strategy in elective aortic arch surgery, associated with similar morbidity and mortality in comparison with bilateral antegrade cerebral perfusion, even if total arch replacement is required. Bilateral antegrade cerebral perfusion reveals a trend of higher incidence of stroke, probably due to manipulation on the arch vessels.

Our data suggest that selective antegrade cerebral perfusion in combination with moderate-to-mild systemic hypothermia (≥28 °C) can be safely and reproducibly applied to surgery for acute type A aortic dissection and offers sufficient neurological and visceral organ protection.

Selective antegrade cerebral perfusion with moderate systemic hypothermia appears to be a safe and sufficient tool for brain protection during AAD repair. In avoiding deep hypothermia, this technique may help to reduce cardiopulmonary bypass time and hypothermia-related side effects.

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