A New Approach for Abdominal Aortic Aneurysm by a Ringed Y Graft

Abstract

Nonsuture technique with ringed Y graft (RYG) was applied to 5 high-risk patients with abdominal aortic aneurysm (AAA). All showed marked arterio sclerotic changes. In 3 cases, the AAA was located 1 cm below the renal artery branching. Concomitant diseases were: gastric ulcer in 3 cases, chronic bron chitis in 3, moderate renal failure in 2, thoracic aortic aneurysm in 1, and aortic valvular insufficiency in 1. The RYG method was evaluated by comparing age, size of aneurysm, operating time, blood loss, and aorta clamping time with the conventional Y graft (CYG) method (10 cases). Ages and sizes in the RYG group were nearly identical with those in the CYG group. The mean blood loss was 797 ± 86 ml in the RYG group and 1631 ± 754 ml in the CYG group (p < 0.05). Aorta clamping time was 34 ± 2.4 min in the RYG group and 62 ± 4.9 min in the CYG group (p < 0.01). Although the suprarenal aorta was clamped in 3 of 5 cases in the RYG group, proximal anastomosis took only a few minutes, and none of them required protection to the kidney. The authors conclude that RYG can be reliably applied to high-risk patients with AAA.