The outcomes of prosthetic bypass grafting for chronic mesenteric ischemia

This study aims to analyze early and late outcomes of the prosthetic bypass grafting procedure in the treatment of chronic mesenteric ischemia.

Twenty-two patients (15 males, 7 females; mean age 60±10 years; range, 32 to 78 years) who underwent prosthetic bypass grafting for chronic mesenteric ischemia due to atherosclerosis between March 2009 and March 2017 were included in this study. The demographic and operative data were analyzed retrospectively.

The most common risk factors for atherosclerosis were hypertension, diabetes, and hyperlipidemia. A total of 72% of the patients were active tobacco users. The common symptoms were postprandial angina and weight loss. Six patients (27%) had a history of endovascular intervention for mesenteric revascularization. Celiac artery bypass grafting was performed in 17 patients, while superior mesenteric artery bypass grafting was performed in 21 patients. Retrograde bypass was done in all patients and polytetrafluoroethylene grafts were used in 20 patients (90%). The mean hospital stay was 10.5 days and the mean follow-up was 44.7 months. The most common postoperative complications were respiratory failure (9%) and infection (9%). In-hospital mortality was observed in one patient (%4.5)who had acute myocardial infarction-related low cardiac output. One patient had graft thrombosis resulting in early graft infection a month after discharge. Late graft thrombosis was observed in two patients at 44 and 85 months, respectively. Late mortality was observed in two patients due to malignancy and cerebral bleeding, respectively.

Prosthetic bypass grafting via open surgery for chronic mesenteric ischemia seems to be an effective treatment in long-term and can be implemented with low surgical risks.