Jebara V A, Fabiani J N, Acar C, Chardigny C, Julia P, Carpentier A
Department of Cardiovascular Surgery, Hôpital Broussais, Paris, France.
Arch Surg. 1994 Mar;129(3):275-9. doi: 10.1001/archsurg.1994.01420270051012.
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.
Prospective consecutive sample study.
Ten male patients who underwent concomitant aortoiliac and coronary revascularization with the ascending aorta as the source of inflow to the femoral arteries between 1989 and 1991.
One hospital death was unrelated to the surgical technique. All survivors displayed an uneventful recovery and were free of symptoms. Follow-up was obtained in all nine cases, they all stayed asymptomatic in terms of coronary artery disease and peripheral vascular disease. Echo-doppler studies showed perfect patency of the aorto-femoral grafts in all cases.
This study shows that the ascending aorta to bifemoral bypass constitutes an interesting alternative in selected cases mainly those with severe ischemia coronary 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 position behind the muscles of the abdominal wall is not compressible, (4) the ascending aorta is the source of inflow, and (5) it allows a shorter duration of hospital stay.
冠状动脉疾病与主-髂动脉疾病常并存。在罕见情况下可能需要同时进行手术。本研究报告我们在升主动脉至双股动脉搭桥手术方面的经验。
前瞻性连续样本研究。
1989年至1991年间，10例男性患者接受了以升主动脉为流入股动脉来源的同期主-髂动脉和冠状动脉血运重建术。
1例医院死亡与手术技术无关。所有幸存者恢复顺利且无症状。9例均获随访，他们在冠状动脉疾病和周围血管疾病方面均无症状。超声多普勒检查显示所有病例的主-股动脉移植物均通畅良好。
本研究表明，升主动脉至双股动脉搭桥手术在特定病例中是一种有意义的替代方法，主要适用于严重冠状动脉缺血和下肢缺血患者。它具有以下优点：（1）操作简便，（2）无需进行腹腔内手术，（3）移植物位于腹壁肌肉后方不易受压，（4）升主动脉为流入源，（5）可缩短住院时间。
