The usefulness of nonabsorbable polymer clips for the closure of supra-aortic vessels' stump

When performing translocated total arch replacement using a frozen elephant trunk, the closure of supra-aortic vessels' stump may be necessary. Herein, we describe the application of a nonabsorbable polymer Hem-o-lok clip for the closure of the stump. The supra-aortic vessels were looped using cloth tapes and clipped using Hem-o-lok clips with gentle traction of cloth tapes. Then, the supra-aortic vessels were sharply transected, leaving a 2-mm cuff of tissue. There were no incidents of clip failure during application or migration, and no significant intra-operative or post-operative bleeding occurred due to clipping failure. Hem-o-lok clips are an easy, quick, and reliable method for the closure of supra-aortic vessels' stump. Therefore, we recommend this technique for translocated total arch replacement procedures performed using a frozen elephant trunk.