Ascending aorta to lower limbs revascularization for reoperation via ministernotomy

The extra-anatomic bypasses, femorofemoral or axillofemoral, have been performed in selected patients for lower extremity revascularization of aortoiliac occlusion. However, significant graft occlusion rate does exist and reoperation constitutes an increasing proportion of vascular surgery practice. We presented our experience in a high-risk patient who received bypass surgery for the third time using the ascending aorta as the source of inflow with good result.