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In situ replacement with equine pericardial roll grafts for ruptured infected aneurysms of the abdominal aorta  Hiroshi Yamamoto, MD, Fumio Yamamoto,

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Presentation on theme: "In situ replacement with equine pericardial roll grafts for ruptured infected aneurysms of the abdominal aorta  Hiroshi Yamamoto, MD, Fumio Yamamoto,"— Presentation transcript:

1 In situ replacement with equine pericardial roll grafts for ruptured infected aneurysms of the abdominal aorta  Hiroshi Yamamoto, MD, Fumio Yamamoto, MD, Kazuyuki Ishibashi, MD, Mamika Motokawa, MD  Journal of Vascular Surgery  Volume 49, Issue 4, Pages (April 2009) DOI: /j.jvs Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

2 Fig 1 Preoperative computed tomographic images of Patient 1, showing a rupture of abdominal aortic aneurysm (A and B) and fusiform aneurysms of both iliac arteries (C). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

3 Fig 2 Operative findings after in situ replacement of abdominal aorta.
Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

4 Fig 3 Construction of a custom-made equine pericardial roll graft. A bifarcated equine pericardial roll is constructed by rolling up and stitching a rectangular patch of equine pericardium (Edwards Lifesciences; Irvine, Calif). A piece of rectangular patch (A) is trimmed to a trapezoid with two base lengths of π (3.14) times the roll diameters (DA and 2DB), rolled up and connected to two separate rolled-up equine pericardial patches (B) with the diameter of DB. DA, diameter for proximal anastomosis; DB, diameter for distal anastomosis; LA, length of patch A; LB, length of patch B; π, circular constant; α, margin to stitch up. Numerical formulae and figures in the parentheses indicate actual sizes for Patient 1. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

5 Fig 4 Postoperative computed tomographic images of Patient 1 (15 months after surgery), showing neither graft dilation (A) nor pseudoaneurysm at the proximal anastomosis (B) and the distal anastomosis (C). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

6 Fig 5 Computed tomographic images of Patient 2. Preoperative ruptured aorta and adjacent opacified extra-aortic space (A). No fluid accumulation around graft and omentum at postoperative day six (B). (G, equine pericardial roll graft; Om, omentum). No graft dilation or pseudoaneurysm at 24 (C) and 48 (D) months after surgery. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

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