BACKGROUND: Neurologic sequelae of open heart surgery for congenital heart disease were related with preexisting brain lesion as well as intraoperative causes. These causes are microemboli, blood flow, and blood distribution. METHODS: This study was designed to examine neurologic sequelae and postoperative course in patients with arterial switch operation using continuous flow cardiopulmonary bypass through retrospective chart review. RESULTS: Of 22 patients 4 had neurologic sequelae. Cooling rate, extubation time, and duration of ICU admission and hospital admission were statistically different between the patients with neurologic sequelae or not. Patients with neurologic sequelae had more rapid cooling rate and longer duration of intubation, ICU stay, and hospital admission than patients without neurologic sequelae. CONCLUSIONS: Cooling rate (time to lower 1oC body temperature) is the only factor among perfusion variables to affect on neurologic sequelae. Neurologic complications make it longer to wean the mechanical ventilation, and to stay at ICU and hospital.