title: Concomitant femoro-femoral bypass graft during surgery for acute type A dissection to treat lower limb malperfusion.
abstract: We report the case of a 69-year-old male patient who was admitted to our department with an acute type A dissection complicated by ischemia of the left lower limb. During surgery for acute type A dissection, the patient underwent concomitant femoro-femoral crossover bypass graft placement to ensure blood supply of the left lower limb during surgery and minimize ischemia-reperfusion injury. The patient underwent supracoronary replacement of the ascending aorta while in deep circulatory arrest with a deepest core temperature of 25°C. Postoperative computed tomography showed antegrade perfusion and patency of the crossover bypass. Postoperative course was eventless without sequelae, especially of the left lower limb. We conclude that concomitant crossover bypass graft reduces the risk of ischemia-reperfusion injury in lower limb ischemia in patients undergoing surgery for acute type A dissection.
authors.affiliation: University Clinic for Cardiac Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria. Electronic address: roman.gottardi@gmail.com.
authors.forename: Roman
authors.initials: R
authors.lastname: Gottardi
authors.affiliation: University Clinic for Cardiac Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Michaela
authors.initials: M
authors.lastname: Resetar
authors.affiliation: University Clinic for Anesthesia and Intensive Care, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Bacher
authors.affiliation: University Clinic for Cardiac Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Edgars
authors.initials: E
authors.lastname: Freilibs
authors.affiliation: University Clinic for Cardiac Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Niuscha
authors.initials: N
authors.lastname: Taheri
authors.affiliation: University Clinic for Cardiac Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Steindl
authors.affiliation: University Clinic for Cardiac Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Catharina
authors.initials: C
authors.lastname: Schreiber
authors.affiliation: University Clinic for Cardiac Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Rainald
authors.initials: R
authors.lastname: Seitelberger
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications* / Q000601:surgery*; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000150:complications* / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000379:methods