Adventitial Wrap Technique for Acute Type A Aortic Dissection

We describe a simple and reproducible technique to achieve complete and immediate hemostasis of the distal anastomosis in total arch replacement with the frozen elephant trunk technique. The adventitia was left seamlessly 1.0 cm longer than the level of the suture line. The adventitial remnant covered most of the distal anastomosis line tightly while the distal anastomosis was completed with continuous sutures. The adventitia was thin and tough, making it suitable to cover the suture line. This technique can contribute to eliminating bleeding from the distal anastomosis independent of unreliable blood coagulability during aortic surgery for acute aortic dissection.