title: Ascending Aorta to Hepatic and Mesenteric Artery Bypassing, in Patients with Chronic Mesenteric Ischemia and Extensive Aortic Disease-A Case Report and Review of the Literature.
abstract: Chronic mesenteric ischemia (CMI) is a rare disorder caused by severe stenosis of the mesenteric arterial supply that results in postprandial pain and weight loss. Treatment options are surgical or endovascular. Surgical bypass can be performed in an antegrade fashion from the supraceliac abdominal aorta (AA) or the distal descending thoracic aorta or in a retrograde fashion from the infrarenal aorta or the common iliac artery. However, in some patients with disease of the descending thoracic aorta or the AA, another site for the proximal anastomosis needs to be found. In this article, we report the case of a 69-year-old man with a thoracoabdominal aortic aneurysm and CMI in whom we performed bypass grafts to the hepatic and superior mesenteric arteries using the ascending aorta as the site for the proximal anastomoses via a median sternolaparotomy. In addition, we performed a literature review of all similar cases and provide an analysis of this technique and an assessment of the success rates.
authors.affiliation: Department of Cardiac Surgery, St George's Hospital, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Barr
authors.affiliation: Department of Cardiac Surgery, Evaggelismos Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kokotsakis
authors.affiliation: Department of Cardiac Surgery, Evaggelismos Hospital, Athens, Greece.
authors.forename: Pantelis
authors.initials: P
authors.lastname: Tsipas
authors.affiliation: Department of Cardiac Surgery, Evaggelismos Hospital, Athens, Greece.
authors.forename: Prodromos
authors.initials: P
authors.lastname: Papapavlou
authors.affiliation: Department of Cardiac Surgery, Evaggelismos Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Velissarios
authors.affiliation: Department of Cardiac Surgery, Evaggelismos Hospital, Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Kratimenos
authors.affiliation: Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK. Electronic address: jgbarr85@gmail.com.
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D001011:Aorta / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002908:Chronic Disease; D000072226:Computed Tomography Angiography; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery*; D065666:Mesenteric Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012501:Saphenous Vein / Q000637:transplantation*; D016896:Treatment Outcome