Overview of Mesenteric Artery Bypass Surgery

A mesenteric artery bypass is a procedure used to treat a blockage in your superior mesenteric artery. It involves using a graft sourced from another blood vessel or a synthetic material to create a new pathway for blood to flow.

Your superior mesenteric artery provides blood to parts of your intestines and pancreas. It branches off the aorta, the largest artery in your body. A blockage to your superior mesenteric artery can be fatal if left untreated.

A mesenteric artery bypass can be a lifesaving procedure, but it’s a major surgery that comes with some risks. Read on to learn more about this procedure.

Mesenteric artery bypass purpose

A mesenteric artery bypass aims to treat mesenteric ischemia, a lack of blood supply to your intestines.

Mesenteric ischemia can occur suddenly, often due to a blood clot, or chronically over many years. Atherosclerosis, plaque buildup in your blood vessels, is the underlying cause in more than 95% of chronic cases.

Research indicates that people living with chronic mesenteric ischemic have a 5-year chance of dying approaching 100% if not treated.

Other causes of mesenteric ischemia include:

• traumatic injury
• mesenteric aneurysm rupture
• arteritis (inflammation of your artery)
• a rare blood vessel disorder called fibromuscular dysplasia

Mesenteric artery bypass may be used to treat mesenteric artery syndrome

, where the aorta and superior mesenteric artery compress your small intestines.

It may also be used to treat a superior mesenteric artery aneurysm when endovascular surgery may be difficult. An aneurysm is a bulging and weakened section of a blood vessel.

Mesenteric artery bypass complications and risks

Potential complications include:

• general anesthesia reaction
• pneumonia
• bleeding
• kidney failure
• blood clots
• acute respiratory failure
• heart attack
• infection

In a small 2018 Turkish study Respiratory failure and infection were the most common complications among 22 people with chronic mesenteric ischemia who received celiac artery bypass or mesenteric artery bypass. One of the 22 people in the study died in the hospital.

Mesenteric bypass failure

One potential risk of a bypass is that the graft will fail, meaning that blood won’t flow through your artery properly. If this happens, you’ll likely need another surgery.

The rates of graft failure vary depending on the artery they’re used to treat. For example, research indicates the failure rate for bypasses in the lower extremities is about 20%

 within a year and 50% within 5 years.

How effective is mesenteric artery bypass?

Mesenteric bypass is associated with excellent long-term

 survival based on the available research. In one study All 10 people who received a bypass to treat a tear in the superior mesenteric artery survived. None of them developed death of intestinal tissue. It should be noted that this is a very small sample size and may not be representative of overall effectiveness.

What happens in mesenteric artery bypass surgery?

Here’s a general idea of what you can expect.

Before the procedure

A mesenteric artery bypass is typically performed under general anesthesia, meaning you’ll be asleep during your procedure.

If your surgery is planned, you’ll receive tests like imaging and a fitness assessment to see if you’re healthy enough to receive general anesthesia.

General anesthesia is usually administered through an IV inserted into a vein in your wrist or arm.

During the procedure

Here’s a general idea of what to expect during your procedure.

1. Your surgeon will make an incision in your abdomen to access your superior mesenteric artery. If they’re using another blood vessel as a graft, they’ll make another incision to harvest it. This incision is often made in your groin to access your greater saphenous vein
2. Your surgeon will sew the graft onto your aorta and mesenteric artery past the blockage.
3. Part of your intestines may need to be removed if the tissue has died.
4. Your wounds will be closed with stitches or staples and covered in dressing.

After the procedure

You’ll wake up from your procedure in the recovery area in the hospital. You’ll likely be connected to an IV and have a catheter in your bladder. You’ll likely also be connected to other machines to measure your vitals.

Preparing for mesenteric artery bypass

It’s important to tell your doctor about any medications or supplements you’re taking. You may have to clear out your bowel the night before your procedure by drinking a special liquid.

You will not be able to eat for at least 6 hours and drink at least 2 hours before your procedure.

Mesenteric artery bypass surgery recovery

In the 2018 Turkish study, researchers found that the average hospital stay was 10.5 days.

Full recovery from major vascular surgeries can take 2–3 months, according to the United Kingdom’s National Health Service (NHS). You may be able to return to your job after about 6–12 weeks.

How much does a mesenteral artery bypass cost?

The cost of your surgery can depend on factors like where the procedure is performed and the extent of your procedure.

The nonprofit FAIR Health estimates that 80% of procedures to repair an aneurysm of the liver, kidney, stomach, or intestines with a graft cost less than $6,836 in Boston with anesthesia potentially costing another $6,009.

Your insurance may pay for most of your procedure. For example, Medicare Part A covers the cost of inpatient hospital care after you pay a deductible.

Alternatives to mesenteral artery bypass surgery

Alternative treatments for mesenteric ischemia include:

• medications, such as:
  • papaverine (Pavabid Plateau, Papacon, others)
  • heparin, warfarin (Coumadin and Jantoven)
  • thrombolytic drugs
• balloon angioplasty to widen your blood vessel and relieve the blockage
• surgery to place a stent, either performed through an endovascular surgery or open surgery

Endovascular surgeries are performed using a long tube inserted into your bloodstream. They’ve become more common to treat mesentery ischemia than bypass surgery.

Frequently asked questions about mesenteric artery bypass

Here are some frequently asked questions people have about mesenteric artery bypass.

What happens when the mesenteric artery is blocked?

A blockage to your superior mesenteric artery can lead to poor blood flow to your intestines. Left untreated, your bowel tissue may die, which may cause gastrointestinal symptoms or life threatening complications.

What is the survival rate of mesenteric artery bypass?

In the 2018 Turkish study, 1 out of 22 people treated with celiac or mesenteric artery bypass died in the hospital. The long-term survival of a mesenteric artery bypass is excellent

What is mesenteric artery bypass surgery?

Mesenteric artery bypass surgery is a procedure used to treat a blockage in the superior mesenteric artery, which supplies blood to parts of the intestines and pancreas. A graft is used to create a new pathway for blood flow.

Why is this surgery performed?

This surgery is performed to treat mesenteric ischemia, a condition where the intestines do not receive enough blood supply. This can be caused by a blood clot, atherosclerosis, or other factors. If left untreated, it can be fatal.

What are the risks and complications of this surgery?

As with any major surgery, there are potential complications, including:

• General anesthesia reaction
• Pneumonia
• Bleeding
• Kidney failure
• Blood clots
• Acute respiratory failure
• Heart attack
• Infection
• Bypass graft failure

How effective is mesenteric artery bypass surgery?

Research suggests that mesenteric artery bypass surgery is associated with excellent long-term survival rates. However, it is important to discuss the potential benefits and risks with your doctor.

What happens during the surgery?

The surgery is performed under general anesthesia. The surgeon makes an incision in the abdomen to access the superior mesenteric artery. A graft, either from another blood vessel or synthetic material, is then used to bypass the blockage.

What is the recovery process like?

The average hospital stay after surgery is around 10 days. Full recovery can take 2-3 months. You may be able to return to work after 6-12 weeks.

How much does the surgery cost?

The cost of the surgery can vary depending on several factors, including location and the extent of the procedure. Insurance may cover most of the cost.

Are there alternatives to mesenteric artery bypass surgery?

Yes, there are alternative treatments for mesenteric ischemia, including medications, balloon angioplasty, and stent placement. Endovascular surgery is now more commonly used than bypass surgery for this condition.

What happens if the mesenteric artery is blocked?

A blockage can lead to poor blood flow to the intestines, potentially causing tissue death and life-threatening complications.

What is the survival rate of mesenteric artery bypass surgery?

While studies show promising long-term survival rates, it is important to discuss your individual case and potential risks with your doctor.

Takeaway

Mesenteric bypass is used to treat superior mesenteric artery blockages. This artery supplies your pancreas and your intestines with blood. Left untreated, a blockage in this artery can be life threatening.

Endovascular surgery is now more common than a bypass for treating blockages in your superior mesenteric artery, but a bypass may still be performed if the blockage occurs in an area difficult to treat.