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AORTO-ILIAC BYPASS GRAFT

General Information

DEFINITION--Placement of an artificial graft to bypass a blood clot or artery closure in the arteries that supply blood to the abdomen, genital area and legs.

BODY PARTS INVOLVED--Aorta; iliac arteries.

REASONS FOR SURGERY--Restoration of normal blood circulation in the legs.

SURGICAL RISK INCREASES WITH

  • Alcoholism; obesity; smoking.
  • Diabetes mellitus; coronary artery disease; or atherosclerosis.
  • Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.
  • Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--General surgeon or vascular surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

  • Before surgery: Blood and urine studies; arteriograms (See Glossary).
  • After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

  • An incision is made in the abdomen.
  • The abdominal muscles are separated to expose the abdominal organs, which are inspected for undetected disease. (Other surgeries may be performed at this time.)
  • The aorta and iliac arteries are located and clamped to isolate the obstruction.
  • An artificial graft is fashioned and fitted in place. One end fits in the aorta and the other two ends in the iliac arteries.
  • The graft is sewn in place and the clamps are released. Blood can now circulate freely.
  • The muscles of the abdomen are closed in layers. The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

  • Excessive bleeding.
  • Surgical-wound infection.
  • Incisional hernia.
  • Inadvertent injury to the ureter.
  • Impotence; graft infection.
  • Occlusion of arteries beyond the grafted vessels.

AVERAGE HOSPITAL STAY--10 to 14 days.

PROBABLE OUTCOME--Expect complete healing without complications and restoration of normal circulation to legs. Allow about 6 weeks for recovery from surgery.


Postoperative Care

† Move and elevate legs often while in bed to decrease the chance of deep--vein blood clots.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

    being, resume daily activities, including work, as soon as you are able.

  • Avoid vigorous exercise for 6 weeks after surgery. Your doctor will prescribe an exercise program. > Resume driving 5 weeks after returning home. > Resume sexual relations when your doctor has determined that healing is complete.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing. After recovery, your doctor may recommend a diet low in fat and sodium (see Appendix for both diets).


Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

  • You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
  • You experience new symptoms, such as nausea, vomiting, constipation or abdominal swelling.
  • Your feet become cold, discolored or numb.
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