Extra-Anatomic Abdomen-Sparing Ascending Aorto-Femoral Artery Bypass Surgery Showed Good Patency in the Patients Who Had Aorto-Iliac Occlusive Disease

Doosang Kim, Jungeun Kim, Hyungho Park, Taekyu Kweon, Dongju Yun, Jungmoon Kim

Seoul Veterans Hospital, Seoul, Korea (South)

Date, time and location: 2018.05.25 13:30, Exhibition area, 1st Floor. Zone – C

Abstract

Objectives: Aorto-iliac occlusive disease or Leriche’s syndrome is rare and desperate in long-term results, inspite of axillo-femoral/aorto-iliac bypass or kissing balloon with stenting, because of repeated thromboembolic episode in graft/stent and subsequent events.

Methods: From November 2007 to December 2017, 13 patients were enrolled. Median age is 67 years old (range: 39-85, including two octogenarians). Access routes to ascending aorta were full-sternotomy in 12 and Rt. para-sternal incision in 1, respectively. Concomitant procedures were CABG in 11 and LAA excision in 1, respectively.

Results: Median op time is 340 minutes (range: 185-410), and blood transfusion amount is 4 units (range: 0-7). Postop ICU-stay and hospital-stay are 6 days (range: 2-14) and 33 days (range: 11-289), respectively. There was one 30-day operative mortality case (8%: patient who having CRF and critical limb ischemia, expired due to uremia and pneumonia at postoperative 11 days) and three follow-up mortality cases (25%: bed-ridden patient who having pulmonary thromboembolism, deep vein thrombosis, LAA thrombi and AF expired due to lung cancer terminal at postoperative 821 days, the other bed-ridden patient who underwent redo CABG expired due to unknown at postoperative 315 days, CLI patient underwent postop BK amputation and then expired sue to sepsis at postoperative 36 days) and 8 morbidities (pleural effusion, sacral pressure sore, wound dehiscence needs re-closure, bleeding needs re-op, urethral injury, acute graft obstruction needs thrombectomy, LCOS, uremia). Mean survival time, 1-year and 10-year survival rates are 5.496 years (95% C.I. 1.904-9.088), 72% and 48%, respectively. Mean graft-patency time, 1-year and 10-year graft-patency rates are 8.694 years (95% C.I. 6.198-11.191), 86% and 86% respectively by CT angiogram or ultrasound exam.