[Stenoses of the abdominal aorta in young patients]

Twenty-five patients with stenosis of the abdominal aorta were observed during the last twenty years. The etiology was a congenital malformation in 20 patients (80%) and an inflammatory aortitis in five (20%). All patients had associated lesions of the renal artery(ies) and 10 had lesions of the digestive arteries, especially of the superior mesenteric artery. All patients had arterial hypertension but none complained of circulatory impairment in the lower limbs or in the digestive area. Aorto-aortic by-pass was performed in six patients. The lesions of the renal artery(ies) (37 kidneys at risk) were treated by nephrectomy in three cases and vascular repair in 34 cases. Four reconstructions of the superior mesenteric artery were carried out simultaneously. There was no postoperative mortality in the current series. After surgery, arterial hypertension was cured in 83.3% of the patients and improved in 12.5%; only one patient was unchanged. In three patients, deterioration of the repair of the renal artery led to repeat surgery. Aortic repair is to be performed in tight stenoses only (pressure gradient > 30 mmHg) and as near to the puberty age as possible.