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Title
Animation
1. Introduction
2. Surgical Approach
3. Bilateral Groin Incisions and Femoral Exposure
4. Thoracoretroperitoneal Incision and Access to the Retroperitoneum
5. Retroperitoneal Dissection and Exposure of the Aorta
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a. Ultrasound Evaluation of the Aorta and Branches Before Clamping
6. Retroperitoneal Tunnels Over the External Iliacs and Under the Ureters
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a. Administration of Mannitol
b. Heparinization
7. Proximal Anastomosis of Graft to Aorta
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a. Prepare for Anastomosis
b. Occlusion with Side-Biting Clamp
c. Aortic Arteriotomy
d. Aortic Punch
e. Suture Anastomosis
f. Repair Microtearing with Pledgeted Sutures
g. Test Anastomosis
h. Duplex Ultrasonography to Interrogate Anastomosis and Aorta
i. Doppler to Interrogate Blood Flow to Viscera
j. Flush Graft
8. Right Distal Anastomosis of Graft to Femoral Artery
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a. Advance Graft Through Tunnels to Femoral Arteries
b. Arteriotomy
c. Endarterectomy
d. Suture Anastomosis
e. Reperfuse Right Leg and Test Anastomosis
9. Left Distal Anastomosis of Graft to Femoral Artery
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a. Reperfuse Left Leg, Test Anastomosis, and Confirm Distal Perfusion
10. Final Inspection and Hemostasis
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a. Reversal of Heparin
b. Chest Tube
11. Closure
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a. Diaphragm
b. Reapproximation of the Ribs
c. Abdominal Wall
d. Skin and Soft Tissues in Layers
12. Post-op Remarks
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Thoracofemoral Bypass: A Retroperitoneal Approach
J. Miller Allan, MD
;
Victoria Aucoin, MD
;
Benjamin J. Pearce, MD
UAB Hospital
Tags:
Vascular Surgery
Main Text
Procedure Outline
Transcript
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Authors
J. Miller Allan, MD
Victoria Aucoin, MD
Benjamin J. Pearce, MD
Filmed At:
UAB Hospital
Article Information
Publication Date
9/20/2024
Article ID
353
Production ID
0353
Volume
2024
Issue
353
DOI
https://doi.org/10.24296/jomi/353