Abstract
Total aortic arch replacement remains a complex surgical procedure, best practiced in high-volume aortic centers. The following report details the surgical procedure for total arch replacement with selective antegrade cerebral perfusion (SACP) for distal arch aneurysm. Following moderate hypothermic circulatory arrest and SACP, the distal arch, and then the proximal arch, is reconstructed, followed by re-implantation of epi-aortic vessels.