Vascular Anastomosis

Overview

During a vascular anastomosis, your surgeon connects blood vessels together. This procedure works to correct damage or diseased blood vessels and restore blood flow to the affected area.

Candidates for vascular anastomosis

You may need to undergo vascular anastomosis if you have a vein that has been damaged by an injury or health condition.

Risks associated with vascular anastomosis

Potential risks of undergoing this procedure are:

• Anastomosis leak (when the new vein connection leaks)
• Blockage in another blood vessel
• Blood clots that can lead to a pulmonary embolism (PE), deep vein thrombosis (DVT) or heart attack
• Damage to nearby blood vessels
• Infection that can lead to sepsis (serious blood infection)
• Scarring
• Severe bleeding

Preparing for vascular anastomosis

You may need to stop taking certain prescription medications for a period of time before vascular anastomosis; your doctor will provide you details about your medications. You will also need to fast (avoid eating or drinking) for up to 12 hours before the procedure.

Expectations during vascular anastomosis

Vascular anastomosis is performed in a hospital operating room. You will be under general anesthesia for vascular anastomosis, meaning that you’ll be fully asleep.

When possible, vascular anastomosis is performed as a minimally invasive procedure, meaning that the incisions (cuts) will be smaller, and your downtime and scarring will be reduced. In some cases, vascular anastomosis will need to be performed as open-heart surgery. This means that your surgeon will make one large incision (cut) in your chest to access the damaged coronary artery. While the surgeon is performing the surgery, your heart will be temporarily stopped with medication and you will be hooked up to a heart-lung bypass machine to keep blood circulating in your body.

Your surgeon removes a section of healthy artery – often from the lower leg or chest wall – and attaches one end above the damaged area of the vein and the other end below that area. This is known as using a natural conduit. In other cases, the surgeon may use an artificial conduit made out of surgical mesh or plastic. Doing so redirects and restores blood flow around the blocked area of your vein.

Once the surgery is complete, your surgeon closes the chest incision with stitches and surgical glue or bandages. You will likely spend one or two days in the intensive care unit (ICU) following the procedure. After you leave the ICU, you will spend several more days in a typical hospital room. Your doctor will provide you with details on how long you’ll need to rest and take off work and other activities.

Conditions that may need vascular anastomosis

You may need to undergo this procedure in the following situations:

• Aneurysmectomy (surgical procedure to repair an aneurysm or weak area in a vein)
• Connecting a vein from a transplanted organ to your body
• Connecting an artery to a vein for hemodialysis access
• Coronary artery bypass surgery
• Fixing a damaged artery due to a gunshot wound

When to seek care

If you think you may need vascular anastomosis, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a cardiologist for more specialized treatment.