Hepatic artery aneurysm resection and reconstruction
Resection of a hepatic artery aneurysm and reconstruction of the hepatic artery with a saphenous vein graft
00:17 SURGICAL PLANNING
02:03 EXPOSURE & MOBILIZATION
- A 58 year old man presented with an intra-aneurysmal chronic thrombus of the hepatic artery distal to the LGA and splenic arteries and proximal to the GDA.
- Risk of aneurysm rupture is significant and may result in death, so precautions are taken to control all major arterial branches before opening the aneurysm to resect the thrombus.
- The GDA and proximal CHA will be ligated but not divided.
- Following clamping of the left and right hepatic arteries, the proper hepatic artery will be divided sharply with scissors.
- A length of saphenous vein will be resected to use for a jump graft.
- Aorta-to-graft anastomosis will be done using a double-armed suture. The graft will be parachuted into position and both lateral and medial walls reconstructed moving cephalad to caudad.
- Graft-to-hepatic artery anastomosis will also be done using a double-armed suture. The graft will be parachuted into position and both lateral and medial walls reconstructed moving cephalad to caudad.
CT scans (pre-op)
CT scans (post-op)