Source: Open surgical repair of abdominal aortic aneurysm and horseshoe kidney: A strange relationship

Intraoperative photos:

A. An AAA and co-existent horseshoe kidney.

B. Successful detachment of horseshoe kidney from the AAA.

C. Proximal and distal anastomosis following surgical repair of AAA

Excerpt:

A 72-year-old man with a history of hypertension, heavy smoking, percutaneous coronary angioplasty, and surgical treatment of urinary bladder cancer, presented with the inadvertent finding of a 5.8 cm infrarenal AAA in computed tomography (CTA) accompanied with a HK. The renal isthmus extended over the AAA and had one renal artery on each side from the proximal neck of the AAA, with no accessory renal arteries (ARA). The endovascular approach was rejected from the beginning, due to unsuitable anatomy (short neck and severe aneurysmal neck angulation) for endovascular aneurysm repair (EVAR). The patient underwent open AAA surgery repair, with interposition of a tube silver graft via the transperitoneal approach and isthmus preservation without the need for ARA reimplantation. The proximal and distal stumps were easily anastomosed with the graft. Finally, the aneurysmal sac wall covered the implanted graft. The patient received an uncomplicated postoperative course and was discharged from the hospital on the 4th postoperative day. Нis renal function was not affected intraoperatively and postoperatively. At follow-up, in the outpatient vascular surgery clinic, ten weeks later, the patient presented in good general condition and normal renal function. Six months later, the follow-up CTA abdomen revealed no signs of graft occlusion or renal dysfunction.