[Devising a Technique for Distal Anastomosis During Total Arch Replacement Using the Frozen Elephant Trunk...

Frozen elephant trunk( FET) technique is an effective procedure used to repair aortic arch aneurysm and aortic dissection. We modified FET technique in order to reduce bleeding, which we named "delayed deployment technique." This procedure is performed in the following manner: 1. A tube graft is anastomosed to the proximal descending aorta using open distal method. 2. A FET is deployed within the tube graft and the descending aorta. 3. Proximal end of the inner FET and the outer tube graft is trimmed at the same position. 4. A four-branched graft is anastomosed to doubly layered distal grafts. Since the FET is directly connected to the arch graft, anastomotic site in the proximal descending aorta can be free from direct blood flow. In addition, stent portion of the FET supports the aortic anastomosis from inside. We believe this method is useful for hemostasis.