ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
ALTERNATIVE APPROACH FOR REVASCULARIZATION OF EXTREMITIES: EXTRA-ANATOMIC BYPASS GRAFTING
İbrahim Gökşin, Gökhan Önem, Ahmet Baltalarlı, Vefa Özcan, *Ercan Gürses, **Harun Evrengül, *Hakan Doğan, *Hülya Sungurtekin
Pamukkale Üniversitesi Tıp Fakültesi, Kalp Damar Cerrahisi Ana Bilim Dalı, Denizli
*Pamukkale Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon Ana Bilim Dalı, Denizli
**Pamukkale Üniversitesi Tıp Fakültesi, Kardiyoloji Ana Bilim Dalı, Denizli
Background: In this study, we aimed to determine an early mortality rate and primary graft patency, patient’s survival in an avarage follow-up of 2 years for the patients with extra-anatomic bypass (EAB) grafting.

Methods: We reviewed our clinical results retrospectively in total of 14 patients with EAB grafting during the period between june 1995 to june 2001 in our clinic. 13 patients (92.8%) were male and only one patient was female, mean age was 58.4 ± 14 years. Axillobifemoral (AFF) bypass in 5 patients axillofemoral (AF) bypass in 2 patients, femoro-femoral (FF) bypass in 4 patients, axilloaxillary (AA) bypass in 2 patients, obturatory bypass (OB) in 1 patient were performed.

Results: Early mortality rate was 7.2% with one patient. In etiology, Takayasu’s arteritis exists in female patient, atherosclerosis exists in all of the male patients. EAB was performed as primary revascularization in 8 patients, as secondary revascularization in 6 patients. Total of 9 times various vascular interventions before EAB grafting operation were performed due to peripheral arterial occlusive disease in 6 patients. PTCA in 2 patients, CABG in 1 patient, CEA in 1 patient before EAB grafting operation were performed. Obturator bypass was performed due to graft infection in 1 patient with aorto-femoral bypass grafting. During the follow up period, 1 patient due to cerebrovascular event and 1 patient due to cardiac event died. We determined the graft thrombosis in 3 patients with AF, FF and AA bypass grafting. Secondary graft patency was provided through the embolectomy in only 1 patient with occluded graft.

Conclusion: EAB is the method of choice with reasonable mortality/morbidity rate, primary graft patency of 72.2% and patient’s survival of 78.5% in an avarage follow up of 2 years for high risk patient.

Keywords : Extra-anatomic bypass, axillo-femoral, femoro-femoral, axillo-axilary, obturatory bypass
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