Preemptive Frozen Elephant Trunk Technique for Hemostatic Use in Total Arch Replacement

The frozen elephant trunk technique is now a fundamental method of total aortic arch replacement. However, in adults, it is sometimes necessary to perform distal aortic anastomosis on the deep side in the case of infected aortic arch aneurysm or coarctation surgery. We herein report 3 cases (2 infected aortic arch aneurysms and 1 aortic coarctation) in which our novel technique was used to secure hemostasis with a preoperatively sized frozen elephant trunk inserted into the distal anastomosis under median sternotomy alone.