Aorto-bi-Femoral Bypass for Juxtarenal Aortic Occlusion in a Patient with Multiple Co-Morbidities: Report of a Challenging Case

AHM Bashar, S Samad, ASMI Hossain, MN Sabah, K Hasan, M Alauddin
2014 Cardiovascular Journal  
A 60-year-old male presented with a large dry gangrene over the antero-lateral aspect of the middle third of the thigh with severe rest pain for which he had been suffering for 6 months. He gave a history of intermittent claudication with buttock claudication for the last 3 years. The patient was non-diabetic but hypertensive for the last 10 years for which he took irregular medication. He didn't give any history of chest pain but reported having cough and breathlessness. He has been a heavy
more » ... has been a heavy smoker consuming about 20 sticks of cigarette per day for the last 40 years. His family history is positive for hypertension and ischemic heart disease. Drug history included irregular antihypertensive medication, analgesics mostly of NSAID group and antiulcerants. Abstract Aorto-bi-femoral bypass for aorto-iliac occlusive disease is a fairly common procedure in vascular surgical practice. The procedure, despite its extensive nature, is generally well tolerated particularly by those having an infrarenal type of aortic occlusion. Patients having a juxtarenal aortic occlusion require a considerably more expeditious surgery necessitating maneuvers to protect the renal arteries. Surgical risk increases significantly in those having multiple co-morbid conditions. We report here a successful case of aorto-bi-femoral bypass for juxtarenal aortic occlusion in a patient having multiple co-morbid conditions like ischemic heart disease, occluded right renal artery with chronic kidney disease, severe malnutrition, hypertension and chronic obstructive pulmonary disease. (Cardiovasc. j. 2014; 6(2): 170-174)
doi:10.3329/cardio.v6i2.18363 fatcat:f36ihszghfhahn3d6bvar6hzgu