I went for a check-up a few weeks ago and had an ultrasound of my bypass (mesenteric arteries) and unfortunately there is narrowing at the bypass beginning. I have copied what the report is below:
Ms. ( leaving out my last name)returns to us after her aortomesenteric bypass. This was a bifurcated bypass; one limb was sent to the celiac access. In the post-operative period she closed this off; I feel this is due to the acute angle and shortness of the bypass graft. Even so, we followed her transaminases and they were coming down nicely; I did perform an arteriogram before she left and it showed excellent collateralization of the celiac bed from the superior mesenteric artery. The superior mesenteric artery bypass itself was widely patent.
On duplex ultrasound today, the bypass is patent but at the distal anastomosis there is velocity elevation and turbulence. She has relatively no symptoms of post-prandial abdominal pain. Her left upper quadrant abdominal pain persisted for a time but she says this is now gone over the past week. She brought me a print out of her most recent transaminases done a couple of days ago and they are nearly normal in the 20s; her amylase lipase are also minimally increased above lab normal values. She is able to eat without pain and is currently suffering no ill-effects from the bypass operation. Her wound is completely healed.
After reviewing the ultrasound, I feel very comfortable letting her go for another 3 months, at which point I will bring her back for a CT angiogram of her abdomen and pelvis; this also to just check on the small aneurysm of her gastroduodenal artery. I discussed her case and care with (left out doctor's name)
Impression/Plan:
Superior mesenteric artery, left upper quadrant abdominal pain, celiac access occlusion, transaminases elevation. I will see her back in 3 months’ time with a CT angiogram of the abdomen and pelvis.
12/19/2016
Needless to say I was upset to get this news. I don't know if the narrowing is some anatomical issue or if it is from some other issue. If there is narrowing at my next check up then my doctor said I will need an angioplasty. What if that doesn't work? He said my affected arteries are very hard. I will have my esr checked by my primary doctor in a few weeks and will be going back to my rheumatologist, but the doctors at Cleveland Clinic said they don't want to put me on prednisone and other drugs before finding out if the vasculitis is burned out or not.
Has anyone on here had vasculitis in their mesenteric arteries? I would really appreciate any feedback on anyone who has had that or has had the operation that I had.
Thank you
Rivi