After more than a decade of focused research, significant advancements have been made in the technology of cardiopulmonary bypass perfusion (CPB) for Type A aortic dissection (TAAD).¹ Notably, there has been a shift from using selective cerebral perfusion (SCP) with lower body circulatory arrest towards a combined approach with lower body perfusion (LBP) in some centers.^2,3 This integrated perfusion strategy has gained widespread acceptance among clinicians as it effectively addresses hypothermia during CPB, preserves coagulation functions, minimizes organ ischemia-reperfusion injuries, shortens the duration of CPB, and potentially improves patient outcomes.

However, a persistent challenge remains as numerous centers continue to rely on a single roller pump for supplying blood to both the brain and lower body. This reliance limits the ability to independently control perfusion in each region, potentially compromising surgical outcomes. To address this critical concern, our center has pioneered a revolutionary perfusion method utilizing distinct roller pumps to meticulously regulate perfusion in both the brain and lower body. This approach ensures precise and independent perfusion, thereby reducing the risks associated with either over- or under-perfusion of the brain. This article aims to present the outcomes and clinical insights from our center’s adoption of this novel perfusion strategy.