MESENTERIC BYPASS FOR CHRONIC MESENTERIC ISCHEMIA

Chronic mesenteric ischaemia is an uncommon disease that requires trea tment to relieve the symptoms of abdominal angina and to prevent intes tinal infarction. Over a period of 3 years, 12 patients with visceral artery stenosis or occlusion were referred to the authors' service and 10 underwent mesenteric bypass grafting. Both the coeliac and the sup erior mesenteric arteries were revascularized in four patients, and th e superior mesenteric artery alone in six patients, using a variety of grafts and graft configurations. This was done in conjunction with ao rtic graft placement in four cases and with renal bypass in three. All patients survived the procedure. At a mean follow-up of 28 months, on e patient died of myocardial infarction 42 months after surgery, while all survivors are symptom-free. Chronic mesenteric ischaemia can be t reated safely and effectively. The variation in the pattern of mesente ric occlusions and the frequent association with aortic and renovascul ar disease does not allow for a single 'best' technical solution but r equires the surgical procedure to be individually tailored. (C) 1998 T he international Society for Cardiovascular Surgery.