Background: Abdominal aortic surgery requires a period of aortic cross clamping for aort--graft anastomosis.
Abdominal aortic clamping and unclamping are associated with several hemostatic and metabolic changes that represent a great danger to the patients. Aortic clamping has been avoided in cardiac surgery by many devices during off pump coronary bypass surgery.
Aim of the study: Anew device was used to do abdominal aortograft anastomosis without aortic clamping. The aim was to study the feasibility of the technique and avoiding all the changes that occur due to aortic cross clamping and unclamping.
Methods and materials: Aorto-graft anastomosis was done in dogs as an experimental study in the animal laboratory. Graft was anastomosed to the intact aorta without interruption of the flow, then by the use of this new device a rounded stoma was made and a functioning graft was establshed. .Aorta -aortic jump bypass, aortofemoral, aortobifemoral, aortorenal bypasses, and aortocaval shunt were done.
Results: The procedure was done easily and all grafts were functioning. There were some bleeding problems due to needle puncture during suturing the graft to the intact aortic wall. Simple compression and additional sutures helped in hemostasis.
Graft thrombosis occurred in an aortorenal bypass, a single limp of aorto-bifemoral graft and aorto-caval shunt.
Conclusion: Abdominal aortic graft anastomosis could be done without clamping using this new device.It will help in
eliminating changes occurring due to clamping and unclamping.It will be a dual benefit to both the patients and the
anesthesia team in surgery of the abdominal aorta.