Abdominal aortic aneurysm repair in a patient with bilateral autotransplanted kidneys.
The case is presented of a 38-year-old male who presented with a large 10 cm x 8 cm pulsatile swelling in his abdomen. Thirteen years before, internal iliac arteries had been used to treat long segment occlusions and diseased state of both renal arteries. At the same time both kidneys had been transplanted to the iliac fossae. Digital subtraction angiography revealed a huge abdominal aortic aneurysm. Both kidneys were fully functional. As the renal transplants had been done extraperitoneally an easy transperitoneal approach was now possible. The maximum diameter of the aneurysm was 12 cm. An inclusion graft repair was carried out using a 16-mm woven Dacron graft. In the light of the favourable circumstances it was decided not to take any special protective measures against renal ischemia apart from keeping the aortic cross-clamp time short. The patient could be discharged with patent and normally functioning kidneys 10 days after surgery.
Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
K S
KS
Neelakandhan
R
R
Muralidhar
M
M
Unnikrishnan
K
K
Ravimandalam
D000328:Adult; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001025:Aortitis / Q000000981:diagnostic imaging / Q000601:surgery; D001807:Blood Vessel Prosthesis; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000601:surgery*; D007083:Iliac Artery / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation; D014182:Transplantation, Autologous
D011093:Polyethylene Terephthalates