DeBakey et al. first reported the successful resection and repair of a fusiform aneurysm of the aortic arch with replacement graft in 1957.1 Crawford and his associates subsequently developed materials and techniques which have made this procedure, one which used generally to result in high morbidity and mortality, more viable, with decreased morbidity and mortality. Increasing numbers of patients are now undergoing this repair and are resuming normal healthy lives postoperatively. From January 1987 to December 1990, 358 patients underwent surgery using profound hypothermia and circulatory arrest, thus allowing for repairs that probably could not have been achieved successfully under any other condition. It is evident that a major determinant of success was the employment of profound hypothermia and circulatory arrest.
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