Durability of antegrade synthetic aortomesenteric bypass for chronic mesenteric ischemia

Objective: The optimal treatment (endovascular/open repair, conduit, configuration) for chronic mesenteric ischemia (CMI) remains unresolved. This study was designed to review the outcome of patients with CMI treated with antegrade synthetic aortomesenteric bypass. Methods: The study was designed as a retrospective review in an academic tertiary care medical center. Patients with CMI who underwent antegrade synthetic aortomesenteric bypass were identified from a computerized vascular registry (from January 1987 to January 2001) with antegrade synthetic aortomesenteric bypass as intervention. Outcome measures were functional outcome (symptom relief, weight gain) and both graft patency (duplex ultrasound/angiography) and survival rates as determined with life-table analysis. Results: Forty-seven patients (female, 70%; age, 62 ± 12 years) underwent aortomesenteric bypass (aortoceliac/aortosuperior mesenteric, n = 45; aortosuperior mesenteric, n = 2) for CMI (abdominal pain, 98%; weight loss, 83%). In-hospital mortality rate was 11% (four multiple organ dysfunction, one bowel infarction), mean length of stay was 32 ± 30 days, three patients (6%) were discharged to a nursing home, and one (2%) was discharged home on parenteral nutrition (duration 4 months). At a mean follow-up period of 31 ± 27 months, all patients had relief of abdominal pain and 86% had gained weight (at ≥1 year follow-up: mean ideal body weight 103 ± 22%; versus before surgery: 87 ± 17%; P