Aorta Bifurcation Graft
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Aorta Bifurcation Graft

The Aorta Bifurcation Graft course will teach you:

  • The placement of a (bifurcated) graft in the abdominal aorta (and iliac arteries). This is either done to prevent abdominal aortic rupture in case of an abdominal aortic aneurysm (AAA) or in the case of occlusive arterial disease of the abdominal aorta and/or the iliac arteries. This is also a life-saving operation when a AAA has ruptured.

Special attention is paid to the following hazards you may encounter during the Aorta Bifurcation Graft:

  • Superior mesenteric artery injury
  • Venous triad (the adrenal vein, the gonadal vein and a retro-aortic vein) injury
  • Lumbar arteries and veins injury
  • Autonomous nervous  plexus damage
  • Graft infection due to ureter damage
  • Iliac veins injury
  • Inferior and superior epigastric veins injury
  • Preservation of collateral branches of deep femoral arteries
  • Ureteral entrapment
  • Thrombotic complication prevention
  • Ineffective vascular control
  • Aortic wall damage
  • Position of the aortic incision
  • Late aneurysm formation
  • Central control of bleeding
  • Antegrade flushing
  • Retrograde flushing
  • Communication with the anesthesiologist
  • Aortoenteric fistula formation

With the following tips you might perform the Aorta Bifurcation Graft even better:

  • Exposure optimization using a self retaining ring retractor
  • Exposure of the right common iliac artery
  • Gaining additional proximal exposure
  • Ligating or clipping lymphatic vessels
  • Sigmoid mobilization to gain exposure of the common iliac artery
  • Choosing a graft
  • Profundoplasty/ Profunda endarterectomy
  • Facilitating graft insertion
  • Communication with the surgical team
  • Positioning of extra aortic clamp
  • Adjusting distal clamp position
  • Finger compression
  • Bypass procedure in case of occlusive disease of the iliac artery(ies)
  • Palpation of pulsation on dorsal artery of the foot
  • Coverage using omental slip

After studying the Aorta Bifurcation Graft course you are familiar with the most common complications:

  • Bleeding
  • Bowel ischemia
  • Lower extremity ischemia
  • Sexual dysfunction
  • Aortoenteric fistula
  • Spinal cord ischemia
  • Venous thrombosis
  • Graft failure

You might also be interested in:

Abdominal Exposure – Left Medial Visceral Rotation

Step by step

Abdominal cavity approach

A midline incision is made starting a few centimeters above the umbilicus and towards the pubic bone. For more information see: “ABDOMINAL WALL INCISION – MIDLINE”

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