thermic component significantly decreases brain metabolism and oxygen requirements and thus permits a longer period of interrupted blood perfusion to the brain. The cerebral metabolic rate is related exponentially to brain (core body) temperature, with the cerebral metabolic rate decreasing by about 50% for each 6°C drop in brain temperature.6 Disadvantages of DHCA include increased cardiopulmonary bypass (CPB) time, edema formation, coagulopathy, and alteration in many organ functions including the kidney, the brain, vascular smooth muscles, intestinal mucosa, alveolar epithelium, the liver, and the pancreas. 7,8 Based on reports from 8 major cardiac surgery centers in the United States, Europe, and Japan, the risk of permanent neurologic injury after aortic arch surgery using DHCA ranged from 3% to 12%, renal dysfunction from 5% to 14%, pulmonary insufficiency from 5% to 39%, and left ventricular