Chronic Dissecting Abdominal Aortic Aneurysm Coexisting with Horseshoe Kidney Requiring Supra-Renal Clamp and Reattachment of Accessory Renal Arteries
- VernacularTitle:腎動脈上遮断および異所性腎動脈再建を要した馬蹄腎合併解離性腹部大動脈瘤の1例
- Author:
Atsunori KONO
1
;
Atsushi OMURA
1
;
Shunya CHOMEI
1
;
Mari HAMAGUCHI
1
;
Kazunori SAKAGUCHI
1
;
Hidekazu NAKAI
1
;
Katsuhiro YAMANAKA
1
;
Takeshi INOUE
1
;
Kenji OKADA
1
Author Information
- Keywords: horseshoe kidney; chronic dissecting abdominal aortic aneurysm; accessory renal arteries
- From:Japanese Journal of Cardiovascular Surgery 2024;53(1):33-37
- CountryJapan
- Language:Japanese
- Abstract: A 60-year-old man underwent open surgery for chronic dissecting abdominal aorta accompanied with a horseshoe kidney. Through open laparotomy, the abdominal aortic aneurysm was exposed without revision of the horseshoe kidney. Cold ringer solution was infused to accessory renal arteries for renal protection. After supra-renal clamping, proximal anastomosis was then performed at the level just below the renal arteries. Abdominal cross clamp time at the level of the supra-renal arteries was 23 min. Median and right accessory arteries were reattached with an ischemic time of 73 and 103 min, respectively. Although serum creatine was elevated a preoperative level of 1.17 mg/dl to 3.63 mg/dl at postoperative day 2, that was gradually decreased to nearly preoperative level of 1.25 mg/dl at discharge. Postoperative enhanced CT demonstrated patency of the reattached accessory arteries. The patient was discharged without major complication on postoperative day 21. One year postoperatively, his follow-up course was uneventful without deterioration of renal function.
