Thoracofemoral (Thoracic Aortofemoral) Bypass Periprocedural Care

Updated: Nov 28, 2016
  • Author: Dale K Mueller, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Periprocedural Care

Equipment

Equipment employed in performing a thoracofemoral (thoracic aortofemoral) bypass includes the following:

  • Operating table
  • Vascular tray
  • Thoracotomy tray
  • Double-lumen endotracheal tube and bronchial blocker/Univent
  • Ability to perform on-table angiography
  • Bean bag, pillows, and cushions to facilitate positioning
Next:

Patient Preparation

Anesthesia

The thoracofemoral bypass requires general anesthesia, and most prefer left-lung isolation, though the procedure can be conducted with left-lung ventilation and appropriate retraction. Epidural anesthesia for postoperative pain control is also helpful. An arterial line and, often, a central line can be useful for the procedure as well.

Positioning

The patient is placed in a posterolateral thoracotomy position with the left chest at approximately 45º off the horizontal and with the pelvis in a horizontal position. The left arm is kept anteriorly and supported. [1]

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