Among the greatest challenges in cardiovascular surgery today remain operations on aortic arch pathology, supraaortic vessels, and the protection of the brain from hypoxic or ischemic injury during these delicate operations. Since DeBakey's first successful repair of an aortic arch aneurysm in 1957, understanding of the aortic arch pathology, neuroprotective strategies, neuromonitoring and surgical technique have markedly improved. Although the specific surgical procedures have reached an advanced standard and general acceptance, many questions remain unanswered and have contributed to...