Aorta Femoral Bypass Surgery
Aorta Femoral Bypass Surgery is performed to bypass diseased large blood vessels in the abdomen and groin.
Some facts about Aorta Femoral Bypass Surgery:
- People who have blocked blood vessels (aorta or iliac arteries) in the abdomen and pelvis undergo Aortobifemoral bypass surgery when the blockage causes significant symptoms or is limb-threatening.
- Blood is redirected through a graft made of synthetic material, such as polytetrafluoroethyline [PTFE] or Dacron to bypass the blocked blood vessel.
- The graft is sewn to the existing artery.
- These synthetic man-made grafts are mostly used than transplanted natural grafts for aortobifemoral surgery because the blood vessels involved are large.
- Recovery times are longer than for bypass surgery to treat diseased blood vessels in the legs since this surgery is done on large, deep blood vessels inside the abdomen.
- Failed or blocked grafts, Bleeding, Infection, Heart attack, Stroke and Sexual dysfunction caused by nerve damage in the pelvis are some of the risks for aortobifemoral bypass procedure.
- Bypass surgery is suggested for people who have many areas of blockage or a long, continuous blockage in the arteries of the abdomen and/or the pelvis.
Preparation for Aorta Femoral Bypass Surgery:
- A complete physical exam will be done along with a complete review of your medical history, to ensure you are in good health before surgery.
- Blood tests or other diagnostic tests may also be required before the surgery.
- You are recommended not eat or drink for 8 hours before the procedure.
- Inform your doctor if you are sensitive to or are allergic to any medicines, latex, tape, iodine, or anesthetic agents (local and general).
- You should also inform your doctor about all medicines (prescription and over-the-counter), vitamins, herbs, and supplements that you are taking.
- Inform your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medicine, aspirin, or other medicines that affect blood clotting as you may need to stop some of these medicines before surgery.
Procedure for Aorta Femoral Bypass Surgery:
- General anesthesia will be given to you to sleep through the procedure.
- The artificial blood vessel is formed into a Y shape and the single end of the Y is sewn on the aorta.
- The two split ends of the Y will be sewn below the blocked or narrowed areas of the femoral arteries which allows the blood to travel around (bypass) the diseased areas.
- Atherosclerotic lesions are classified and categorized involving the aortoiliac, femoropopliteal, and infrapopliteal regions by taking into account the extent of stenosis, presence of calcification, as well as laterality, length, and complexity of the lesions
- The lesions are classified in categories A to D.
- Type A and B are preferably managed endovascularly, whereas type C, in low-risk patients and type D classifications are candidates for management with surgical bypass.
- Even Type C and D lesions undergo treatment with endovascular therapy as all patients should be considered for endovascular therapy before surgery
- Patients undergoing endovascular techniques will have overall lower costs, shorter length of stay, and lower complications rates.
- Suture is required for the anastomosis of the graft to the native vessel.
- Heparin administration is required for the patient which is a standard prior to clamping any of the blood vessels to help prevent thrombosis.
- Protamine is usually administered towards the end of the case for the reversal of the anticoagulant effect.
- The end-to-end anastomosis is preferred as it allows the graft to lie flatter and thus may lessen the chance of future aortoenteric fistula.
- Retrograde perfusion is allowed into the inferior mesenteric artery by this method.
- EndoVascular RetroperitoneoScopic Technique (EVREST) is a sutureless and clampless technique used during laparoscopic, retroperitoneal aortobifemoral bypass surgery.
