Bowes D E, Keagy B A, Benoit C H, Pharr W F
J Cardiovasc Surg (Torino). 1985 Jan-Feb;26(1):41-5.
Severe juxtarenal aortic disease and occluded aortic bifurcation grafts have prompted surgeons to seek alternative routes when reoperating. We have modified the descending thoracic aortobifemoral bypass procedure by drawing the graft through a retroperitoneal tunnel to the left groin, thereby eliminating the need for an abdominal incision. The lower thoracic area is exposed through a left anterolateral thoracotomy incision and each common femoral artery is exposed by vertical incisions in the groins. The right limb is drawn through a retrorectus tunnel to the right groin for the final anastomosis. Experience with this technique in 12 patients has demonstrated less risk of atheroemboli, less blood loss, shorter operating time, and a more rapid postoperative recovery, than is the case in reentering the abdomen for a secondary aortic procedure.
严重的近肾主动脉疾病和闭塞的主动脉分叉移植物促使外科医生在再次手术时寻找替代途径。我们通过将移植物经腹膜后隧道拉至左腹股沟，对降胸主动脉双股动脉旁路手术进行了改良，从而无需进行腹部切口。通过左前外侧开胸切口暴露下胸部区域，并通过腹股沟的垂直切口暴露每条股总动脉。右肢经腹直肌后隧道拉至右腹股沟进行最终吻合。12例患者使用该技术的经验表明，与再次进入腹部进行二次主动脉手术相比，动脉粥样硬化栓子风险更低、失血量更少、手术时间更短且术后恢复更快。
