Open Repair of a Renal Artery Aneurysm with Hypogastric Artery Autograft and Hypothermic Perfusion Preservation

Nelson De Luccia, André Brito Queiroz*, Grace Carvajal Mulatti, Fábio Rodrigues Ferreira do Espirito Santo and Karina Paulo Domingos Rosa Schneidwind

A 32-year-old woman presented with a one-year history of mild abdominal  pain  in  the  left  upper  quadrant  and  a  palpable  pulsatile abdominal  mass  on  physical  examination.  The  results  of  laboratory investigations,  including  serum  urea  and  creatinine  levels,  were unremarkable.   Contrast   enhanced   computed   tomography   (CT) showed  a  large  left  renal  artery  aneurysm,  measuring  5,0  cm  by  3,5 cm,  but  no  evidence  of  renal  perfusion  alterations  or  other  vascular abnormalities  (Figure  1).  She  had  been  previously  submitted  to  an unsuccessful   endovascular   approach   with   intention   to   treat   the aneurysm  and  preserve  left  renal  perfusion.  Because  she  was  young and  in  good  health  our  purpose  was  to  preserve  left  renal  function and an open repair was adopted. The patient underwent a laparotomy with  midline  incision  and  the  left  kidney,  left  renal  vein  and  artery were   circumferentially   mobilized   from   surrounding   tissues.   To permit  a  much  better  exposure,  left  renal  vein  and  artery  were clamped and transected while the ureter was left intact and the ex-situ reconstruction was performed on the body wall [1-3].

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Published on: Sep 23, 2015 Pages: 12-13

Full Text PDF Full Text HTML DOI: 10.17352/2455-5495.000004
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