Direct true lumen cannulation through aortic incision for cardiopulmonary bypass during surgery for acute Stanford type A aortic dissection was reported by Jacob, followed by Conzelmann who used a Mersilene tourniquet to snag the ascending aorta. Since 2013, Samurai cannulation, a modified version of the direct true lumen cannulation, has been used in surgery for acute type A aortic dissection at Kitasato University Hospital. Here, this surgical technique is described.