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Abdominal Debranching

Date: Jan 26, 2023

Question:

Midline incision - trans-peritoneal exposure of R external iliac artery, SMA, common hepatic artery and Left renal artery and inferior branch of R renal artery distal to bifurcation.

 

2 limb Dacron graft anastomosed to R external iliac (diseased native vessel) with 1 limb anastomosed to SMA and 2nd limb anastomosed to common hepatic artery (extremely diseased native vessel) I'm leaning towards 35633 and 35632,52. Thoughts?

 

PTFE graft sewn from SMA limb of Dacron graft to L renal artery

 Separate PTFE graft sewn from common hepatic artery limb of Dacron graft to R renal artery inferior branch

I'm thinking unlisted for the SMA to L renal and hepatic to R renal. Maybe compared to 35636,50. Thoughts?

Patient is having debranching done prior to EVAR scheduled in the future.

Any help would be greatly appreciated.

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