We investigated various surgical procedure of distal arch aneurysm to propose a safer strategy with less mortality. From January 1998 to March 2001, we operated 10 cases of distal arch aneurysm. Different methods were applied over the years to reach the current improved technique, which is a combination of retro grade general perfusion, median sternotomy, deep hypothermic circulation arrest with selective cerebral perfusion, pharmacological cerebral protection, none touch aortic method, and open distal anastomosis. We have managed to improve postoperative complications, which we experienced many times in the past. We have had no post-operative cerebral accidents, except for 1 case of death by and mesenteric arterial obstruction due to leukemia. In conclusion, our method is safe and feasible and can expect the reduction of post-operative mortality.
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