The surgical redirecting of blood flow around blocked blood vessels which allow the passage of blood to specific organs or parts of the body is a bypass procedure. For blocked coronary arteries, it is called coronary artery bypass. For blocked arteries supplying blood to the lower extremities of the body like the stomach and the medial compartment of the thigh (groin), it is known as aortobifemoral bypass procedure.
Aortobifemoral bypass is a medical procedure, the objective of which is to repair damaged aorta – the largest artery carrying blood and oxygen to our body, originating from the heart and travelling down the stomach to reach the femoral arteries. These femoral arteries are two smaller blood vessels supplying blood and oxygen to the hips and legs.
When the aorta or any blood vessel for that matter is damaged or blocked, the supply of blood and oxygen to the body is greatly affected. Invariable pain, ulcer in the extremities and even gangrene are the obvious indicators of a diseased blood vessel. The showing of these symptoms indicates that blood flow from the heart is not reaching its destinations, which in this case are the lower extremities.
Who Needs Aortobifemoral Bypass?
Aortobifemoral bypass is regarded as the most hard-wearing bypass procedure for the peripheral nervous system. Patients with the following symptoms may be recommended to undergo this surgical procedure.
• Acute Aortic Aneurysm
• Extreme cases of claudication or ulcers / non-healing wounds on lower legs
• Severe abdominal aortic occlusion
• Critical limb ischemia
• Atherosclerosis of the abdominal aorta or iliac arteries
• Kidney transplant patients needing improved blood flow to the new kidney
As the objective of this surgical procedure is revascularization in the arteries or blood vessels, precise assessment or evaluation of the condition of the affected aorta or iliac vessels is very crucial. If this is recommended by your doctor, chances are your artery blockage or narrowing is severe and could pose even more serious harm and danger to your health.
Who Cannot Have Aortobifemoral Bypass Surgery?
Aortobifemoral bypass is an all-embracing procedure which requires the patient to be on general anaesthesia, not all candidate patients can have the surgery. A patient who is on the list below, are not likely to be recommended for this procedure.
• Old, feeble patients who are not physically fit for surgery – their poor health conditions may not withstand the procedure
• Stroke or myocardial infarction patients – they require wide-range of pre-operative workouts as they are at higher risks
• Colostomy patients – their abdomen might not be ready for another surgical procedure
• Retroperitoneal fibrosis patients – they manifest similar symptoms but the causes are different. Requires intensive evaluation of the cause of symptoms before any surgery is recommended to avoid any misdiagnosis or wrong treatment
What are the Post-Surgery Risks?
As in any surgical procedure, aortobifemoral bypass surgery is not an exemption. The common risks are :
• Heart attack
• Kidney Failure / Lung Infection
• Respiratory problems
• Bowel failure
• Infection from the cuts / incisions
• Allergic response to medicines
• Blood clotting in legs or arms
• Graft infection
To avoid other problems or complications, a thorough pre-surgery workup is critical and important. This is to ensure that all high-risks patients have gone through the rigorous pre-op clearance from the concerned doctors (cardiologists, renal and colostomy specialists, etc.)
In general, the expected outcome of aortobifemoral bypass surgery is on the high side, with only about 2-5% mortality rate.