Related Experiment Video
Updated: May 10, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Aortoaxillary bypass during cardiac operation
Giuseppe Gatti1, Manuel Belgrano, Livio Gon
1aCardiovascular Department bDepartment of Radiology, AOU Ospedali Riuniti and University of Trieste, Trieste, Italy.
Insights
This study evaluated aortoaxillary bypass combined with cardiac surgery for patients with subclavian artery disease and heart conditions. The combined procedure showed promising results with symptom improvement and good graft patency.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Proximal atherosclerotic lesion of the subclavian artery often coexists with cardiac disease.
- Surgical treatment for these combined conditions presents unique challenges.
- Aortoaxillary bypass is a potential revascularization strategy.
Purpose of the Study:
- To analyze the experience with aortoaxillary bypass during cardiac operations.
- To evaluate the safety and efficacy of concomitant surgery in patients with combined subclavian artery and cardiac disease.
- To assess the outcomes of this combined surgical approach.
Main Methods:
- A retrospective analysis of nine patients undergoing concomitant aortoaxillary bypass and cardiac surgery.
- Use of ring-reinforced polytetrafluoroethylene grafts for bypass.
- Prospective collection of perioperative data and follow-up assessments.
Main Results:
- Seven left and two right aortoaxillary bypasses were performed.
- No early postoperative complications related to subclavian artery revascularization.
- Symptom improvement in both subclavian artery disease and cardiac conditions at follow-up.
- Excellent graft patency confirmed by computed tomography angiography in most patients.
Conclusions:
- Concomitant aortoaxillary bypass and cardiac operation is a viable option for selected patients.
- The combined procedure appears to not increase perioperative risk.
- Careful attention to graft placement is crucial for optimal outcomes.
Aims:
The aim of the present study was to analyze our experience in the use of the aortoaxillary bypass during cardiac operation in a limited series of patients with proximal atherosclerotic lesion of the subclavian artery combined with cardiac disease amenable to surgical treatment.
Methods:
Of 1953 consecutive patients who underwent cardiac operation at our unit between April 2009 and July 2012, nine (0.5%; four women and five men; mean age 69.0 ± 6.2 years) suffered from symptomatic occlusive disease of the subclavian artery, and underwent concomitant aortoaxillary bypass. A ring-reinforced polytetrafluoroethylene vascular graft was anastomosed to the proximal segment of the axillary artery, introduced into the pleural cavity through the first or the second intercostal space, and anastomosed to the ascending aorta. All perioperative data were collected prospectively.
Results:
Seven (77.8%) left and two (22.2%) right aortoaxillary bypasses were achieved. Ten concomitant cardiac operations were performed. There were no early postoperative complications related to the subclavian artery revascularization. At a mean follow-up of 27.3 ± 15.5 months, both the symptoms of the subclavian artery disease and those of the heart disease improved. High-resolution computed tomography angiography confirmed an excellent patency of the aortoaxillary bypass in all the patients but one.
Conclusion:
Concomitant aortoaxillary bypass and cardiac operation may be an option to keep in mind for patients with coexisting subclavian artery occlusion and heart disease, after the evidence that the combined operation does not increase the risk. Attention should be paid to the course of the bypass graft toward the axillary artery.
Related Concept Videos
01:22Aneurysm IV: Nursing Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management