Novel Approach for Celiac Debranching Utilizing the Gastroduodenal Artery
Thomas Bernik, MD, Daniel Han, MD, Daniel Fremed, MD, Herbert Dardik, MD.
Englewood Hospital & Med. Center, Englewood, NJ, USA.
OBJECTIVES: Utilizing the gastroduodenal (GDA) artery as the source vessel for maintenance of hepato-splenic perfusion during complex suprarenal aneurysm repair and obviating the need for aortic cross-clamping, renal and visceral ischemia. A relatively simple and accessible hybrid revascularization and aneurysm exclusion for complex visceral segment aortic pathology.
METHODS: During debranching surgery for a visceral segment aortic aneurysm, the GDA was dissected and the distal segment was cannulated with an end-to-end GORE hybrid graft. (Fig )
RESULTS: The procedure of using the GDA during hybrid surgery along with GORE hybrid graft enabled rapid and effective anastomosis to provide hepato-splenic blood flow and repair of suprarenal abdominal aortic aneurysm.
CONCLUSIONS: The use of the GDA is a relatively simple and accessible conduit to maintain hepato-splenic perfusion during hybrid repair of a visceral segment aortic aneurysm. 
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