The retroperitoneal approach to aortic surgery associated with horseshoe kidney

The horseshoe kidney is a rare anomaly that can significantly complicate aortic surgery. A bulky isthmus, abnormalities of renal anatomy, and a variable blood supply associated with a horseshoe kidney can pose technical difficulties in terms of aortic reconstruction. The left retroperitoneal approach affords an excellent exposure of the abdominal aorta in patients with a horseshoe kidney without dividing the renal isthmus and avoids the risk of injury to a ureter in an anomalous location. This is a case report of a patient with a horseshoe kidney who underwent a successful repair of an abdominal aortic aneurysm by a left retroperitoneal approach.