Abdominal aortic aneurysm and bilateral pelvic kidneys.

Area of Science:

• Vascular Surgery
• Nephrology
• Anatomical Variations

Background:

• Abdominal aortic aneurysms (AAA) pose significant surgical challenges, especially with complex anatomical variations.
• Bilateral pelvic kidneys represent a rare congenital anomaly that complicates AAA repair.
• Preserving renal function during AAA surgery is paramount, particularly in patients with ectopic renal vasculature.

Observation:

• A 61-year-old male patient presented with a 5.8 cm abdominal aortic aneurysm.
• Incidental computed tomography angiography revealed bilateral pelvic kidneys, a rare anatomical finding.
• The complex anatomy necessitated an open surgical approach for aneurysm repair.

Findings:

• Open surgical repair of the abdominal aortic aneurysm was performed.
• Renal function was preserved using intermittent cold renal perfusion via Fogarty infusion catheters into each renal artery.
• The procedure achieved a short aortic cross-clamp time of 29 minutes.

Implications:

• This case highlights a successful strategy for managing abdominal aortic aneurysms in patients with bilateral pelvic kidneys.
• The described renal perfusion technique offers a viable option for preserving renal function in complex AAA repairs.
• This approach may be applicable to other challenging AAA cases involving renal anomalies.