Aortobifemoral Bypass

Aortobifemoral bypass surgery is considered for people with blocked blood vessels in the abdomen and pelvis, which include the aorta, femoral or iliac arteries. Meanwhile, they must have significant symptoms or be in danger of losing a limb. If they have met these conditions, then a doctor will perform this procedure which involves an aortic bypass graph. This surgery is considered the best procedure for the peripheral system. In this article, aortobifemoral bypass will be discussed in detail.

Aortobifemoral Bypass: What to Expect

This bypass surgery is performed when clogged arteries have significantly decreased blood flow to extremities, leading to pain, gangrene, nerve damage and the possible loss of limbs. And like other kinds of procedures, you'd better get a thorough idea of it before doing it.

1.   Before the Surgery

Along with a complete physical examination and blood tests, there are some tests that will be ordered to help detect which arteries are blocked. These include:

  • Ankle-brachial index. The blood pressure in the arms and legs are measured and compared during this test. A blockage is usually indicated in the peripheral arteries of the legs if the blood pressure in the legs is much lower than that of the arms.
  • Doppler ultrasound. Sound waves are used to help detect which arteries have blockages by examining the blood.
  • Angiography. The location of blockages is detected by injecting dye into the arteries of the legs and then x-rays are taken to show the areas in which blood flow is impeded or blocked.

And you should keep the following in your mind: You cannot eat or drink anything after midnight prior to the procedure. When you are ready to be released from the hospital, have someone drive you home and help take care of you as well. Discuss your medications with your doctor as you may need to stop some of them prior to surgery.

General anesthesia will be administered for the surgery and, if needed, an epidural anesthesia may be used as well. This type of anesthesia is used to numb the body at and below the chest area.

2.   During the Surgery

The aortobifemoral bypass involves making a large incision in the abdomen and cutting through the muscles underneath the skin layers. In order to access the arteries, some organs may need to be moved aside slightly. It will be necessary for the blood flow through the arteries to be stopped during the surgery, which will be done by applying clamps on either side of the blocked portion of the affected artery.

A graft will be inserted with one end attached to the aorta above the blockage and the other end attached below the blocked area to either the femoral or iliac artery. After the graft has been sewn into place, the clamps will be released and the blood flow through the graft will be checked. After everything is put back into place, the incisions will be closed. The entire procedure usually takes about 3 to 4 hours and any discomfort you have after surgery will be managed with prescription medications.

Aortobifemoral Bypass: Aftercare

1.   At the Hospital

Once the surgery has been completed, you will be placed in recovery room and the oxygen tube may be removed, but some patients may still need it for a few days to supply oxygen. From recovery, you will be moved to ICU where you will be monitored for 1 to 2 days. During that time, an incentive spirometer will be used to help keep your lungs clear to prevent pneumonia and you may also be given a medication to prevent blood clots.

After being moved out of ICU, it will probably be 1 or 2 days before you are allowed out of bed. Most people will be in the hospital for 5 to 7 days after the procedure, but your length of stay will depend on your rate of recovery and overall health.

2.   At Home

After being released from the hospital, you should be able to resume some of your normal activities in about 4 to 6 weeks. Your total recovery time, depending on your health, will probably take about 2 to 3 months. To help reduce your recovery time, here are some suggestions for taking care of yourself.

  • Medications. You should take any medications you are prescribed as directed, especially blood thinners and antibiotics. Always take the full course of antibiotics to help prevent infections. Your doctor will let you know when you can restart any medications you were taking before your surgery.
  • Incisioncare. Carefully wash the incision area with warm, soapy water every day and pat it dry. If it rubs against your clothing or seeps, you can cover the incision with a gauze bandage, but change it every day. You must keep the incision area clean and dry while it is healing.
  • Diet. You should be able to eat normally, but if your stomach gets upset, eat bland foods like boiled chicken, plain rice, yogurt or toast. And if afraid of constipation, take a daily fiber supplement. For water, unless been told not, otherwise, make sure to drink plenty of fluids daily.
  • Activities. While you should be able to resume normal activities after about six weeks, take it easy. Rest when you feel tired and exercise by taking short walks. Do not engage in sex or strenuous activities until cleared by your doctor.

When to Call a Doctor

You should call your doctor immediately if you notice any bleeding, swelling, severe pain, redness or warmth around the incision site. He or she should also be contacted if your temperature is 101.4 or higher, if your chest hurts or it is hard to breathe, if the surgical site looks different or you have any of the same symptoms that you had before the aortobifemoral bypass.