COMBINED CORONARY AND FEMORAL REVASCULARIZATION USING AN ASCENDING AORTA TO BIFEMORAL BYPASS

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. Desig n: Prospective consecutive sample study. Patients: Ten male patients w ho underwent concomitant aortoiliac and coronary revascularization wit h the ascending aorta as the source of inflow to the femoral arteries between 1989 and 1991. Results: One hospital death was unrelated to th e surgical technique. All survivors displayed an uneventful recovery a nd were free of symptoms. Follow-up was obtained in all nine cases; th ey all stayed asymptomatic in terms of coronary artery disease and per ipheral vascular disease. Echo-doppler studies showed perfect patency of the aorto-femoral grafts in all cases. Conclusions: This study show s that the ascending aorta to bifemoral bypass constitutes an interest ing alternative in selected cases mainly those with severe ischemia co ronary 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 positon behind the muscles of the abdominal wall is not compressible, (4) the asceneding aorta is the source of inflow, and ( 5) it allows a shorter duration of hospital stay.