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Fig. 11. —Intraoperative sonogram of 78-year-old man after supraceliac
aorta to celiac and superior mesenteric artery bypass graft. Longitudinal
sonogram with spectral Doppler analysis reveals intraluminal flap
(arrow) associated with elevated velocity consistent with a
flow-limiting dissection in native common hepatic artery just beyond distal
anastomosis. These findings are consistent with major abnormality and should
prompt revision. After revision with repair of intimal flap, repeat sonogram
was normal.
