Abstract
Background:Concerning abdominal aortic aneurysm (AAA) repair in case of horseshoe kidney, it is controversial whether transection of the isthmus should be performed. We performed AAA repair with a horseshoe kidney with transection of the isthmus. Case: A 76-year-old man was referred to us for AAA repair. Preoperative abdominal CT revealed a horseshoe kidney, of which the isthmus had no pyelocaliceal systems. No aberrant renal arteries (ARA) were revealed preoperatively. At operation, the abdomen was explored via a long midline incision. After transection of the isthmus, we found one ARA from the AAA wall to the lower right side kidney. The AAA was replaced with a woven bifurcated graft, and the ARA was reconstructed. Results: Postoperative hemotological examinations showed no sign of renal dysfunction, and we visualized the patent reconstructed ARA with the postoperative MR angiography. Conclusion: Transection of the isthmus was a beneficial method to replace AAA in this case with horseshoe kidney, facilitating exposure of the entire AAA and to confirm an existence of ARAs. We were able to perform AAA replacement and reconstruction of ARA easily with a good operative view.
