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A D V E R T I S E M E N T
Neoaortoiliac System (NAIS) Bypass of Infected Aortofemoral Graft: 10
A D V E R T I S E M E N T
Moist laparotomy packs were placed in the thigh incisions and attention was turned to the abdomen for exposure of the aortic graft. This was performed through a midline abdominal incision. Following evisceration of the intestines to the patient's right side, the duodenum was mobilized, and the posterior peritoneal surface was incised directly over the graft. A large collection of pus surrounding the graft was identified near the aortic anastomosis.
The graft was unincorporated and easily exposed to the proximal anastomosis. A 5 cm segment of infrarenal aorta was cleared above the anastomosis for placement of a cross-clamp.
Neoaortoiliac System (NAIS) Bypass of Infected Aortofemoral Graft: 11
A D V E R T I S E M E N T
Next, the veins were harvested from the thigh and prepared for implantation. After transecting the veins at the knee, each SFPV was exposed to the level of the confluence with the profunda femoris vein.
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Neoaortoiliac System (NAIS) Bypass of Infected Aortofemoral Graft: 12
A D V E R T I S E M E N T
The proximal superficial femoral vein was transected and oversewn flush with the common femoral vein junction. Meticulous closure is critical to prevent creation of a residual "stump" of superficial femoral vein in which a thrombus might form with potential for pulmonary embolus. Likewise, the profunda femoris vein flow should not be impeded.
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This page was last modified on 11/6/2000.
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