Ascending aorto-superior mesenteric artery bypass as a surgical option for revascularization in mesenteric ischemia associated with type B aortic dissection.
We report the case of an acute ischemia of the superior mesenteric artery (SMA) after endovascular fenestration of a complicated acute type B aortic dissection. An initial attempt for endovascular revascularization of the SMA failed, and an ascending aorto-superior mesenteric artery bypass was urgently performed to salvage the small bowel. Surgery of patients in these specific settings is more complex because an adequate, more distal inflow vessel is often not present due to the dissected aorta and iliac arteries. This surgical option could be lifesaving and should be part of the vascular surgeon's armamentarium.
Division of Cardiovascular Surgery, University Hospital of Geneva, Medical School, University of Geneva, Geneva, Switzerland. Electronic address: Afksendyios.kalangos@hcuge.ch.
Afksendiyos
A
Kalangos
Division of Cardiovascular Surgery, University Hospital of Geneva, Medical School, University of Geneva, Geneva, Switzerland.
Gino
G
Gemayel
Division of Cardiovascular Surgery, University Hospital of Geneva, Medical School, University of Geneva, Geneva, Switzerland.
Dominique
D
Vala
Division of Cardiovascular Surgery, University Hospital of Geneva, Medical School, University of Geneva, Geneva, Switzerland.
Ebrahim
E
Khabiri
Division of Cardiovascular Surgery, University Hospital of Geneva, Medical School, University of Geneva, Geneva, Switzerland.
Damiano
D
Mugnai
Division of Cardiovascular Surgery, University Hospital of Geneva, Medical School, University of Geneva, Geneva, Switzerland.
Nicolas
N
Murith
D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D001011:Aorta / Q000503:physiopathology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000503:physiopathology / Q000601:surgery*; D065666:Mesenteric Ischemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D012086:Reoperation; D013152:Splanchnic Circulation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome