What is a mesenteric artery bypass?
Mesenteric artery bypass is a surgical procedure that creates an alternate route (bypass) for blood to flow from the aorta (body’s largest artery) to the mesenteric artery (artery that supplies blood to the intestines). The bypass is made from a vein or from artificial material and is attached above and below the blocked area. Once the bypass is in place, blood circulation to the intestines is restored.
Why is a mesenteric artery bypass done?
Mesenteric artery bypass is used to treat chronic mesenteric ischemia, a condition in which an artery that supplies blood to your small intestine is blocked by a clot or narrowed from atherosclerosis.
Plaque buildup on the inside of your arteries causes them to harden and become damaged. Plaque consists of fatty substances, cholesterol, cellular waste products, calcium and fibrin deposits. If not treated, blockages and narrowing of the arteries can lead to life-threatening conditions.
Chronic mesenteric ischemia is often associated with severe stomach pain that occurs after eating. This recurring pain can lead to weight loss and other symptoms, such as diarrhea, nausea and vomiting. If not treated, chronic mesenteric ischemia can become acute and require an emergency procedure.
Prior to proceeding with mesenteric artery bypass, your doctor will conduct a history and physical to determine your symptoms. You may be asked to undergo some tests to determine the amount of narrowing in your vessels. These tests may include:
If one of these tests demonstrates that your arteries have narrowing, you may be asked to have an angiogram (X-ray of blood vessels to identify blockage).
At The Ohio State University Wexner Medical Center, our vascular surgeons are experienced in diagnosing mesenteric ischemia, and in all forms of treatment for mesenteric ischemia, including minimally invasive angioplasty and stenting, and open surgical bypass for more complex cases.
What to expect during mesenteric artery bypass
Preparing for the surgery
Tell your doctor about all of the medications you’re taking, including over-the-counter medications, and also if you are allergic to any medications.
You may be asked to undergo bowel preparation to clear out your bowel the night before your procedure.
You’ll also be asked to refrain from eating or drinking after midnight before the morning of your procedure.
During your procedure
Mesenteric bypass is a major operation done through an incision in the abdomen. You’ll be given general anesthesia for this surgery.
During a mesenteric artery bypass, your surgeon will create a new path for blood to flow around a blocked artery. To create the alternate route, your doctor may use either a vein from another part of your body or a synthetic tube.
If using a healthy vein rather than a synthetic one, the procedure begins by making a small incision, often in your thigh, to harvest a small vein to be used for the bypass.
The healthy vein, or synthetic vein, will be sewn (grafted) onto your aorta, then attached to the mesenteric artery below the blockage — thereby allowing blood to go around the blocked area and freely toward your intestine.
Your surgeon may also inspect your intestines for any indication of cell death, called gangrene. The surgeon will remove any dead tissue that is found.
After your procedure
Immediately after surgery, you’ll typically stay in the intensive care area for one or two days.
Due to the seriousness of this procedure, you can expect to remain in the hospital for about one week after surgery, depending on your recovery and overall health.
You’ll be given antibiotics and watched closely following mesenteric artery bypass.
Once you return home, continue taking all prescribed medications. You’ll have several follow-up visits scheduled to monitor your recovery.
You should be able to return to most normal daily activities about a month after the surgery.
Risks of mesenteric artery bypass
There are rare, but possible, risks of mesenteric artery bypass surgery, including:
- Infection
- Bruising or bleeding at the incision location
- Blood clot moving from mesenteric artery into the bowel, which may require additional surgeries to fix
What are the benefits of this procedure?
By having this procedure to fix mesenteric ischemia, you’ll avoid a potentially life-threating emergency. This surgery will help protect your vital organs, including small intestine, by providing unimpeded blood and oxygen flow.