Long-term results of aorta-superior mesenteric artery bypass using a new route.
OBJECTIVE
Several methods of revascularization after mesenteric ischemia have been proposed. Using a new route, we performed retrograde loop bypass grafting to the superior mesenteric artery (SMA) with a ringed expanded polytetrafluoroethylene (ePTFE) graft.


METHODS
We anastomosed the graft to the infrarenal aorta, which ran behind the left renal hilum, turned ventral, and was anastomosed to the SMA in an antegrade fashion hemodynamically. Five patients underwent this procedure, which resulted in remarkable symptomatic relief.


RESULTS
There were no postoperative deaths or serious complications, although some patients suffered paralytic ileus. All of the grafts remained patent during long-term follow-up, ranging from 17 to 72 months (mean: 37.8 months). Postoperative angiograms showed good configuration of the graft, which did not compress the renal vessels.


CONCLUSIONS
Infrarenal aorta-SMA bypass relieved mesenteric ischemia and achieved good long-term graft patency. Thus, we consider it to be an effective and durable vascular procedure to reduce postoperative mortality and morbidity.
Department of Vascular and Applied Surgery, Tokyo Medical and Dental University, Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Yoshinori
Y
Inoue
Norihide
N
Sugano
Takehisa
T
Iwai
D000714:Anastomosis, Surgical / Q000379:methods; D000783:Aneurysm / Q000601:surgery; D001012:Aorta, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery; D008297:Male; D017538:Mesenteric Artery, Superior / Q000601:surgery*; D008641:Mesenteric Vascular Occlusion / Q000601:surgery; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D013997:Time Factors; D014654:Vascular Patency
D011138:Polytetrafluoroethylene