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Aneurysms of the aortic arch are among the most challenging cases for surgical treatment and require procedural expertise for their safe conduct. Up to now, 3 main strategies for cerebral protection of patients undergoing extensive aortic surgery have been developed and studied. These are straight deep hypothermic circulatory arrest (DHCA), retrograde cerebral perfusion (RCP), and ante grade cerebral perfusion (ACP).

This study was conducted to assess the effects of the currently suggested protocol for bivalirudin on hemostatic activation during cardiopulmonary bypass with and without cardiotomy suction.