Superior Mesenteric Artery Bypass Grafting from the Ascending Aorta Using a Saphenous Vein Graft for Treatment of Acute Aortic Dissection with Abdominal Malperfusion:Report of a Case Hirofumi Fujii 1 , Shigeki Koizumi 1 , Tadaaki Koyama 1 1Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital Keyword: Stanford type A acute aortic dissection , mesenteric malperfusion , superior mesenteric artery bypass , central repair pp.388-391
Published Date 2021/5/1
DOI https://doi.org/10.15106/j_kyobu74_388
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A 50-year-old man presented with abdominal pain and numbness in the right leg. He was diagnosed with type A acute aortic dissection with malperfusion of the superior mesenteric artery (SMA) and the right external iliac artery. Before median sternotomy, we made median celiotomy and anastomosed a saphenous vein graft to SMA. After cardio-pulmonary bypass was instituted, perfusion to the saphenous vein graft was started. After the central repair, we selected the vascular graft of the ascending aorta as the inflow of SMA bypass because leading the vein graft to the external iliac artery was difficult due to obesity and intestinal edema. The graft flow was favorable with 100 ml/minute. He was discharged on postoperative day 56 without any abdominal complications. Some reports suggested that early reperfusion improved the outcomes of surgery for acute aortic dissection with mesenteric ischemia. The ascending aorta may be a viable alternative as an inflow of SMA bypass when the iliac artery is inappropriate.

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