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Herein, we describe the case of a 78-year-old female patient presenting with TAAD complicated by malperfusion of the left lower extremity and an entry tear localized to the ascending aorta. During the initiation of cardiopulmonary bypass (CPB), a pronounced bilateral discrepancy in radial mean arterial blood pressure (mABP) was identified, alongside a significant reduction in cerebral tissue oxygenation index (TOI) and the oxyhemoglobin change rate (\u0394HbO<jats:sub>2<\/jats:sub>). To mitigate the malperfusion, pulsatile flow (PF) was utilized during CPB. This report elucidates the meticulous application of PF during CPB in the management of this complex malperfusion scenario, culminating in a favorable postoperative outcome.<\/jats:p>","DOI":"10.1051\/ject\/2025011","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T14:43:51Z","timestamp":1743605031000},"page":"153-159","source":"Crossref","is-referenced-by-count":0,"title":["An effective case of pulsatile flow for cerebral malperfusion of stanford type A aortic 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