Combined coronary and femoral revascularization using an ascending aorta to bifemoral bypass
V. A. Jebara, J. N. Fabiani, C. Acar, C. Chardigny, P. Julia and A. Carpentier
Department of Cardiovascular Surgery, Hopital Broussais, Paris, France.
OBJECTIVE: Coronary artery and aortoiliac disease frequently coexist. In
rare instances simultaneous procedures may be required. This study reports
our experience with ascending aorta to bifemoral bypass. DESIGN:
Prospective consecutive sample study. PATIENTS: Ten male patients who
underwent concomitant aortoiliac and coronary revascularization with the
ascending aorta as the source of inflow to the femoral arteries between
1989 and 1991. RESULTS: One hospital death was unrelated to the surgical
technique. All survivors displayed an uneventful recovery and were free of
symptoms. Follow-up was obtained in all nine cases, they all stayed
asymptomatic in terms of coronary artery disease and peripheral vascular
disease. Echo-doppler studies showed perfect patency of the aorto-femoral
grafts in all cases. CONCLUSIONS: This study shows that the ascending aorta
to bifemoral bypass constitutes an interesting alternative in selected
cases mainly those with severe ischemia coronary and leg ischemia. It
offers the following advantages: (1) it is easy to perform, (2) does not
require an intraperitoneal procedure, (3) the graft's position behind the
muscles of the abdominal wall is not compressible, (4) the ascending aorta
is the source of inflow, and (5) it allows a shorter duration of hospital
stay.
