Mesenteric artery bypass is a surgical procedure used for the treatment of chronic mesenteric ischemia. Mesenteric ischemia is decreased circulation in the arteries that supply blood to your small intestine.
Mesenteric ischemia is usually caused by atherosclerosis (thickening or hardening of the arteries) or a clot that blocks blood flow in your mesenteric arteries. The primary symptom associated with mesenteric ischemia is severe pain in your abdomen following meals. Mesenteric ischemia can build up over a period of years (chronic) or can arise and worsen quickly (acute), requiring immediate medical attention.
Why Choose The Ohio State University Medical Center?
At Ohio State’s 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 Is 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 prosthetic man-made material and is attached above and below the blocked area. Once the bypass is in place, blood circulation to the intestines is restored.
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:
- CT scan (computed tomography scan, also called CAT scan) – An imaging procedure that uses X-rays and computer technology to produce cross-sectional, detailed images of the body, including bones, muscles, fat and organs.
- Duplex ultrasound - A painless, noninvasive test that shows how blood is moving through your arteries and veins. It examines the structure of your blood vessels and indicates if there are any blockages within your arteries.
- MRA (magnetic resonance angiography) – A noninvasive imaging procedure that uses large magnets, radiofrequencies and a computer to evaluate blood flow through arteries.
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).
Why Have Mesenteric Artery Bypass?
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.
What to Expect During Mesenteric Artery Bypass
Preparing for Your Procedure
Tell your doctor about all of the medications you are 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 will 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. The procedure is done under general anesthesia. During a mesenteric artery bypass, a vein or prosthetic bypass is grafted (sewed) onto your aorta and then onto the mesenteric artery, creating an alternate route for blood to flow to the intestines.
After Your Procedure
You will be placed on antibiotics and closely monitored following mesenteric artery bypass. Patients can expect to be in the hospital about one week after surgery. Return to normal functioning occurs after about a month. Once you return home, you should resume taking your medications unless your doctor instructs otherwise. You will continue to be monitored during periodic follow-up visits.