SURGERY OF THE ABDOMINAL AORTA IN PATIENTS WITH HORSESHOE KIDNEY

S.I. Lotina, L.B. Davidovic, B.R. Vojnovic, D.M. Kostic, D.B. Velimirovic, P.Lj. Petrovic, M.V. Perisic-Savic, N.S. Kovacevic
Center for Vascular Surgery of the Institute for Cardiovascular Diseases,
Institute for Abdominal Diseases of the Serbian Clinical Centre,
Belgrade, Yugoslavia

The authors present 5 patients with horseshoe kidney who underwent surgery on the abdominal aorta during last 12 years. Four of them were male, one was female and the average age was 57.8 (33-70) years. Three patients had abdominal aortic aneurysm and two aorta-iliac occlusive disease. The Crawford type I of horseshoe kidney vasculariwtion has been found in one case, type III in 3, and type III in I case.

Following procedures on the abdominal aorta have been done:

partial aneurysmectomy and tubular graft replacement (one case);
partial aneurysmectomy and bifurcated graft replacement (one case);
exclusion of the aneurysm and bifurcated graft replacement (one case);
one aorta-bifemoral and one axillo-bifemoral bypass graft in cases with aorta-iliac occlusive diseases.

In four transabdominal procedures, isthmus has been preservated and vascular grafts were placed behind it. In one case anomal renal arteries were removed from the anterior aneurysm swallandreimplantedin thegraft using Carrel patch technique. The average follow up period was 5 years (9 months to 12 years). In this period there were no signs of graft occlussion, renovascular hypertension and renal failure. One patient died 5 years after operation due to myocardial infarction. These cases illustrate the factors which complicate the operation of the abdominal aorta in patients with horseshoe kidney: the isthmus, the anomalous renal vessels and anomaly of the kidney excretory system.

P. 114-122

« Back