General Thoracic and Cardiovascular Surgery

, Volume 67, Issue 1, pp 102–110 | Cite as

Brain protection in aortic arch aneurysm: antegrade or retrograde?

  • Amer Harky
  • Matthew Fok
  • Mohamad BashirEmail author
  • Anthony L. Estrera
SPECIAL EDITION Controversies in Surgery for Thoracic Aorta


During open aortic arch repair, there is an interruption of cerebral perfusion and to prevent neurological sequelae, the hypothermic circulatory arrest has been established to provide sufficient brain protection coupled with adjuncts including retrograde and antegrade cerebral perfusion. To date, brain protection during open aortic arch repair is a contested topic as to which provides superior brain protection with little evidence existing to suggest supremacy of one modality over the other. This article reviews current literature reflecting on key and emerging studies in brain protection and their associated outcomes in patients undergoing open aortic arch surgery.


Aorta Aneurysm Cerebral perfusion Brain protection Aortic arch Circulatory arrest Thoracic aortic surgery 


Compliance with ethical standards

Conflict of interest

There are no conflicts of interest or sources of support.


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Copyright information

© The Japanese Association for Thoracic Surgery 2017

Authors and Affiliations

  • Amer Harky
    • 1
  • Matthew Fok
    • 2
  • Mohamad Bashir
    • 1
    Email author
  • Anthony L. Estrera
    • 3
  1. 1.Department of Cardiac Surgery, Barts Heart CentreSt Bartholomew’s HospitalWest SmithfieldUK
  2. 2.Department of Aortic ServicesLiverpool Heart and Chest HospitalLiverpoolUK
  3. 3.Department of Cardiothoracic and Vascular SurgeryMcGovern Medical SchoolUT HealthUSA

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