Straight deep hypothermic circulatory arrest: Should we definitively give up or should we keep on?

In their retrospective monocentric study, Damberg and colleagues1 highlight their experience with the use of deep hypothermic circulatory arrest (DHCA) as a cerebral protection strategy during aortic arch operations. The authors analyzed data on 613 consecutive patients between 2003 and 2015. The majority of patients (n = 529; 86.3%) underwent elective surgery, and 474 (77.3%) underwent hemiarch replacement. Total aortic arch replacement was performed in 125 patients (20.4%). The authors reported a stroke incidence of 2% (n = 12), whereas minor cerebral damage, such as seizure and temporary neurologic deficit, were observed in 1% (n = 6) and 5.1% (n = 31), respectively.

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