Aortobifemoral bypass surgery is done to redirect blood flow around narrowed or blocked blood vessels in the abdomen, pelvis, or groin. If the obstruction is in the arteries of the pelvis, the bypass must be done from the aorta in the abdomen to the femoral arteries in the groin.
When is aortobifemoral bypass needed?
You may need an aortobifemoral bypass if there is a blocked artery in your abdomen, pelvis, or groin. Blocked arteries are often caused by a buildup of fatty deposits, which is called atherosclerosis.
When atherosclerosis develops in the arteries that provide blood to the legs, the condition is called peripheral arterial disease.
Narrowing or even complete blockage of the arteries to the legs may result in a range of complications depending on the severity. Some people exhibit no symptoms at all, whereas others have discomfort during activity (intermittent claudication). If the circulation to the legs deteriorates further, chronic discomfort in the foot and gangrene may develop.
Before bypass surgery is considered, however, the obstruction must be producing considerable symptoms or be life-threatening.
How is aortobifemoral bypass done?
Aortobifemoral bypass is done under general anesthesia, and the procedure takes about 3-5 hours to complete on average.
During the procedure
During the surgery, aortoiliac occlusion is treated with synthetic grafts using an aortofemoral bypass. Through an abdominal midline incision, the distal aorta is exposed and dissected (separated) from the renal arteries to the inferior mesenteric artery, allowing for a more complete reconstruction.
Your surgeon will bypass the obstructed artery by inserting a prosthetic blood vessel into your body that has the appearance of an upside-down Y. The bottom of the Y will be sewn to your aorta just above the damaged section of the artery in your abdomen, where it will remain for many months. To connect the two upper halves of the Y to the femoral arteries below the blocked location, the Y will be divided in two. This allows more efficient circulation of the blood around (bypassing) damaged regions.
The femoral arteries are the major arteries that run down the inside of each of your legs. Following the insertion of this graft, blood will be able to flow from your aorta to your femoral arteries by circumventing the blocked section of the aorta.
After the procedure
After surgery, you will be in the hospital for 4-7 days.
You can expect to experience pain, discomfort, and fatigue for several weeks after the procedure. You will most likely need to take at least 4-6 weeks off from work depending on the sort of job you perform and how you are feeling at the time.
After 4-6 weeks, you may be able to resume normal activities. However, it will likely take 2-3 months for you to completely heal, particularly if you engage in a lot of physical activity regularly.
What are possible complications after aortobifemoral bypass?
Possible complications of the surgery include:
- Chest infection or breathing difficulty; there is a 20% chance of this occurring, and the likelihood is increased if you smoke)
- Bowel damage (burst bowel or ulcer); the risk is higher if you have had prior abdominal surgery or an incident of peritonitis
- Leg swelling
- Infection from the incision
Dellehunt RE, Manna B. Aortofemoral Bypass. [Updated 2022 Jan 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. https://www.ncbi.nlm.nih.gov/books/NBK542328/
Bhimji S. Aortic Bifemoral (Aortobifemoral) Bypass Technique. Medscape. https://emedicine.medscape.com/article/1830241-technique
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