ABDOMINAL AORTIC-ANEURYSM REPAIR WITH ARTERIAL BRANCH RECONSTRUCTION - UTILITY OF THE TEMPORARY BYPASS TECHNIQUE

Between June 1992 and May 1996, five patients underwent an abdominal a ortic aneurysm (AAA) repair with concomitant arterial branch reconstru ction. All of the patients were males ranging in age from 55 to 66 yea rs (mean: 61.6 years). The operations were performed for a localized a bdominal aortic dissection, a pseudoaneurysm after patch angioplasty o f a supraceliac AAA, a pararenal AAA, a total AAA with retrograde desc ending thoracic aortic dissection, and a supraceliac AAA after an infr arenal AAA repair. All patients underwent bilateral renal artery (RA) reconstruction. Three patients also lead a concomitant reconstruction of the superior mesenteric artery ad celiac axis The renal arteries we re preferentially reconstructed Visceral circulation during aortic cro ss-clamping was maintained via a temporary bypass circuit. A temporary division of the left renal vein was necessary in two patients. Overal l, the mean renal ischemia time was 17.2min (range: 10 to 32 min). The re was one perioperative death due to sepsis from a graft infection. A nother patient died 6 months postoperatively clue to pyothorax. One pa tient required postoperative hemodialysis for 1 month. Based on the ab ove findings, the temporary bypass technique is thus considered to be useful for maintaining physiologic organ perfusion during aortic clamp ing without the need to use any complicated devices.