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The procedure consists primarily of paraesophagogastric devascularization achieved by dividing the perforating veins of the esophagus and the stomach while maintaining the plexus of collaterals that connect the coronary gastric vein to the azygous system.
The left gastric vein runs from right to left along the lesser curvature of the stomach. [2] It passes to the esophageal opening of the stomach, where it receives some esophageal veins. [2] It then turns backward and passes from left to right behind the omental bursa. It drains into the portal vein near the superior border of the pancreas. [2]
This leads to varices in the esophagus and stomach, which can bleed; B) a needle has been introduced (via the jugular vein) and is passing from the hepatic vein into the portal vein; c) the tract is dilated with a balloon; D) after placement of a stent, portal pressure is normalized and the coronary and umbilical veins no longer fill.
The gastric bypass reduces the size of the stomach by well over 90%. [4] A normal stomach can stretch, sometimes to over 1000 mL, while the pouch of the gastric bypass may be 15 mL in size. The gastric bypass pouch is usually formed from the part of the stomach that is least susceptible to stretching.
Coronary artery bypass graft surgery has been in practice since the 1960s. Historically, vessels—such as the great saphenous vein in the leg or the radial artery in the arm—were obtained using a traditional "open" procedure that required a single, long incision from groin to ankle, or a "bridging" technique that used three or four smaller incisions.
A vein from the leg is removed and grafted to the coronary artery to bypass a blockage at LAD. Coronary artery bypass surgery during mobilization (freeing) of the right coronary artery from its surrounding adipose tissue (yellow).
Gastric varices are dilated submucosal veins in the lining of the stomach, which can be a life-threatening cause of bleeding in the upper gastrointestinal tract. They are most commonly found in patients with portal hypertension , or elevated pressure in the portal vein system, which may be a complication of cirrhosis .
Coronary collateralization is considered a normal response to hypoxia and may be induced, under some circumstances, by exercise. It is considered to be protective. [1] Collateral or anastomotic blood vessels also exist even when blood supply is adequate to an area, and these blood vessels are often taken advantage of in surgery. Some notable ...
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