Abstract
A 75-year-old man was admitted with a diagnosis of suprarenal abdominal aortic aneurysm (SRAAA), 70 mm in maximum diameter. Three-dimensional computed tomography showed two polar renal arteries (RA) on both sides, and three of them arose from the aneurysm, except for the left upper RA. Operation was performed through a median full laparotomy. After suprarenal aortic clamping and opening of the aneurysm, a temporary shunt was employed from the left axillary artery to three polar RAs using a heparin-coated tube. Proximal anastomosis was performed with 18 × 9 mm woven Dacron bifurcated graft, and three polar RAs were anastomosed to the graft in order, under infusion of 150 ml cold Ringer’s solution for each. The distal anastomoses were made to the bilateral common iliac arteries, and the inferior mesenteric artery was finally reconstructed to the graft. He went an uneventful postoperative course without deterioration of renal function, and discharged 22 days after surgery. In surgical treatment of SRAAA, this technique is very useful because it can shorten the renal ischemic time and provide physiologic organ perfusion during graft replacement.
