Conclusion
BHAS reduces myocardial ischemic time, which can be very valuable, especially when long and complex intracardiac procedures are required. Both strategies are associated with satisfactory mid-term reduction of reintervention and reoperation rates. Given the lower incidence of ARF and delayed sternal closure in the postoperative period and similar mid-term outcomes, we believe that the BHAS strategy should be preferred technique for aortic arch repair in neonatal patients.