[Synchronous revascularization surgery of supraaortic trunks and abdominal visceral arteries. Case report]

The clinical case of a 50 years old female is reported, who was admitted at our hospital in very poor general condition, in a physical and psychologic state of exhaustion, due to a mesenteric vascular insufficiency syndrome (abdominal angina), for the last three years. She underwent a conventional angiographic evaluation, disclosing an occlusion of both the celiac axis and superior mesenteric artery and at the level of the aortic arch, an occlusion of the innominate artery associated to an ostial stenosis of the left common carotid artery was also found. The coronary circulation was normal. The patient underwent surgical management consisting in the bowel revascularization trough a supraceliac aortic bypass to both the hepatic and superior mesenteric arteries, followed by a supraaortic trunks revascularization by means of a bypass graft from the ascending aorta to both common carotid arteries. The extensive procedure was well tolerated by the patient and the post-operative course was normal, with the exception of an acute respiratory insufficiency promptly managed with intensive and non-invasive care and she was discharged on day 14th, asymptomatic and with a gain weight of 7 kilos. The unusual and eventually unique character of this simultaneous surgery justifies its presentation, as well as a discussion on the advantages and contraindications of such approach, that revealed itself as an efficient and extremely well succeeded procedure.