THORACIC AORTA TRANSOBTURATOR BIPOPLITEAL BYPASS AS EVENTUAL DURABLE RECONSTRUCTION AFTER REMOVAL OF AN INFECTED AORTOFEMORAL GRAFT

A 36-year-old man was referred with aortofemoral graft infection and p erigraft duodenal erosion. The aortofemoral graft was removed, and bil ateral axillo-superficial femoral grafts were constructed. Recurrent f ailures of these grafts prompted us to convert to a more-durable recon struction. A straight graft was anastomosed to the lower thoracic aort a, routed retroperitoneally, and attached to an inverted U-shaped bila teral transobturator bypass graft, which was anastomosed to both above -knee popliteal arteries. After 3 years, the patient has remained well and the grafts are patent. This operation represents a durable in-lin e reconstruction that avoids all previously infected areas after remov al of an infected aortofemoral graft.