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Abdominal aortic surgery and horseshoe kidney
Lazar B Davidović1, Dusan M Kostić, Nenad S Jakovljević
1Institute for Cardiovascular Diseases, Clinical Center of Serbia, 8, K. Todorovića Street, Belgrade, 11000, Serbia. lazard@eunet.yu
Annals of Vascular Surgery
|December 16, 2004
Summary
Horseshoe kidney patients can safely undergo abdominal aortic surgery. Preoperative diagnosis and renal artery management are crucial for successful outcomes, with no increased mortality observed in this study.
Area of Science:
- Vascular Surgery
- Urology
- Nephrology
Background:
- Horseshoe kidney is a congenital anomaly that complicates abdominal aortic surgery.
- Management strategies for these patients require careful consideration due to potential vascular variations.
Purpose of the Study:
- To evaluate morbidity and define optimal management for patients with horseshoe kidney undergoing abdominal aortic surgery.
- To assess the safety and outcomes of aortic procedures in this unique patient population.
Main Methods:
- Retrospective review of 15 patients with horseshoe kidney undergoing abdominal aortic surgery over 20 years.
- Analysis of preoperative imaging (ultrasonography, CT, angiography) and intraoperative findings.
- Evaluation of surgical techniques, including renal revascularization and preservation of the renal isthmus.
Main Results:
- 80% of horseshoe kidneys were detected preoperatively; 66.6% had anomalous renal arteries.
- 10 patients required renal revascularization (Carrel patch or aortorenal bypass).
- Two perioperative deaths occurred in patients with ruptured abdominal aortic aneurysms; long-term follow-up showed no graft occlusion or renal complications.
Conclusions:
- Abdominal aortic surgery is safe in patients with horseshoe kidney, without increased mortality.
- Precise preoperative diagnosis and management of anomalous renal arteries, including reimplantation, are essential.
- Preservation of the renal isthmus is a key surgical consideration.