Dong SB, Xiong JX, Zhang K, et al. - Researchers here appraised the application of moderate hypothermic circulatory arrest (MHCA) with a core temperature of 29 °C and bilateral selective antegrade cerebral perfusion in acute type A aortic dissection (aTAAD) managed by total arch replacement with stented elephant trunk implantation. The modified group comprised 25 aTAAD patients who underwent total arch replacement with stented elephant trunk implantation via MHCA (29 °C) and bilateral selective antegrade cerebral perfusion and the controls comprised 36 patients who were treated by the same procedure with MHCA (25 °C) and unilateral selective antegrade cerebral perfusion. MHCA (29 °C) and bilateral selective antegrade cerebral perfusion applied in total arch replacement with stented elephant trunk implantation for aTAAD resulted in acceptable outcomes, yielding similar inferior cerebral and visceral protection compared with that of the conventional strategy. The shorter duration of ventilation and ICU stay, as well as a reduced volume of drainage and red blood cell transfusion, may be due to the greater core temperature.