What is aortobifemoral bypass surgery?

An aortobifemoral bypass is surgery to move blood flow around narrowed or blocked blood vessels in your belly or groin area. This will increase blood flow to your legs. This may relieve symptoms such as leg pain, numbness, and cramping. You may be able to walk longer distances without leg pain.

The doctor will use a graft to bypass the narrowed or blocked blood vessels. The graft is made of human-made material. The graft will carry blood from the aorta to the femoral artery. This artery is in the groin area of each thigh. The aorta is the large blood vessel that carries blood from the heart to the blood vessels in the belly. The femoral arteries are large blood vessels that carry blood from the blood vessels in the belly to the legs.

You will probably be asleep during this surgery. The doctor will make a cut in your belly. The doctor will also make a cut in your groin at the top of each thigh. These cuts are called incisions. The doctor will put the graft in through the incisions. The graft is connected to the aorta and the femoral arteries. Stitches or staples are used to close the incisions.

You may spend at least several days in the hospital. You will need to take it easy for at least 4 to 6 weeks at home.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 6 weeks or until your doctor says it is okay.
• For 6 weeks, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• Hold a pillow over your belly incision when you cough or take deep breaths. This will support your belly and decrease your pain.
• Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
• Ask your doctor when you can drive again.
• You may need to take at least 4 to 6 weeks off from work. It depends on the type of work you do and how you feel.
• Ask your doctor when it is okay for you to have sex.

Diet

• Eat heart-healthy foods. These include fruits, vegetables, and whole grains. If you have not been eating this way, talk to your doctor. You also may want to talk to a dietitian. This expert can help you learn about healthy foods and plan meals.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Take pain medicines exactly as directed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Your doctor may prescribe a blood thinner when you go home. This helps prevent blood clots. Be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.

Incision care

• If you have strips of tape on the incisions, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it oozes or rubs against clothing. Change the bandage every day.
• You may shower as usual. Pat the incisions dry. Do not take a bath for the first 2 weeks or until your doctor tells you it is okay.

Bypass surgery can improve blood flow and relieve intermittent claudication.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

All surgeries carry a certain amount of risk. These risks include:

• Infection.
• Bleeding.
• Heart attack or stroke.

Specific risks for aortobifemoral bypass surgery include:

• Leg swelling.
• Failed or blocked grafts.
• Kidney problems.

An aortobifemoral (say "ay-OR-toh-by-FEM-uh-ruhl") bypass is surgery to redirect blood flow around narrowed or blocked blood vessels in your belly or pelvis. Your doctor will use a human-made blood vessel, called a graft, to bypass the narrowed or blocked blood vessels. These diseased blood vessels are caused by peripheral arterial disease. The surgery is done to get more blood flow to the legs.

You may spend several days in the hospital. Your belly and groin will be sore for several weeks. You will probably feel more tired than usual for several weeks.

You may be able to do many of your usual activities after 4 to 6 weeks. But you will likely need 2 to 3 months to fully recover.

You may need to take at least 4 to 6 weeks off from work. It depends on the type of work you do and how you feel.

You will have regular tests to check for problems with the graft.

An aortobifemoral bypass is surgery to redirect blood around narrowed or blocked blood vessels in your belly or groin. The surgery is done to increase blood flow to the legs. This may relieve symptoms such as leg pain, numbness, and cramping. You may be able to walk longer distances without leg pain.

The doctor used a human-made blood vessel, called a graft, to bypass the narrowed or blocked blood vessels. The graft will carry blood from the aorta to the femoral artery in each thigh. The aorta is the large blood vessel that carries blood from the heart to the blood vessels in the belly. The femoral arteries are large blood vessels that carry blood from the blood vessels in the belly to the legs.

You can expect your belly and groin to be sore for several weeks.

You will probably feel more tired than usual for several weeks after surgery. You may be able to do many of your usual activities after 4 to 6 weeks. But you will probably need 2 to 3 months to fully recover, especially if you usually do a lot of physical activities.

You will have regular tests to check for problems with the graft.

Aortobifemoral bypass surgery is for people who have narrowed or blocked blood vessels (aorta or iliac arteries) in the abdomen and pelvis. Usually the disease must be causing significant symptoms or be limb-threatening before bypass surgery is considered.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery may take at least 3 to 5 hours.
• You will probably go to the intensive care unit (ICU) after surgery. You will probably stay in the ICU for 1 or 2 days before you go to your regular hospital room.