ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Thoracic aortofemoral artery bypass: an alternative procedure for initial treatment of critical aortoiliac occlusive disease
Sabit Sarıkaya, Eray Aksoy, Mehmet Taşar, Ahmet Elibol, Mesut Şişmanoğlu, Ali Fedakar, Kaan Kırali
Department of Cardiovascular Surgery, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2013.6001
Background: The aim of this study is to report our results on the use of thoracic aortobifemoral bypass (TABFB) as an initial surgical approach in treatment of aortoiliac occlusive disease.

Methods: Between July 2006 and October 2010, six male patients (mean age 56.3, range 54 to 65 years) who underwent TABFB surgery were included. Five patients were in Fontaine IIA, while one patient was in Fontaine IIB class. Diagnosis was base on conventional angiography in five patients and contrasted computed tomography in one patient. None of the patients had suprarenal involvement. Two had isolated infrarenal involvement, whereas four had additional juxtarenal involvement. Thoracic aortobifemoral bypass surgery was performed on all patients and an additional coronary artery bypass graft (CABG) surgery was performed in two patients. A 16x8 mm PTFE graft was used in all operations. Its proximal end was anastomosed to the distal thoracic aorta and distal ends were anastomosed to the common femoral arteries bilaterally.

Results: The mean time of surgery was 124.16 minutes. The mean time to extubation was 8.3 hours. The mean drainage volume of postoperative bleeding was 291.6 ml. Two patients suffered from mild dyspnea and pain. None of the patients had pneumothorax and obstruction-related atelectasia. Pleural effusion occurred in one patient (16%) on postoperative third day. Early graft obstruction or wound infection was not seen. The mean time to discharge was eight days.

Conclusion: Thoracic aortofemoral bypass procedure offers an alternative as an initial option to conventional abdominal aortofemoral technique for the treatment of aortoiliac occlusive disease.

Keywords : Aorta, abdominal; aortofemoral artery; thoracotomy
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