Right renal artery re-implantation and supra-coeliac clamping in a supra-renal abdominal aortic aneurysm.

ABSTRACT

Aim: We report the repair of a supra-renal abdominal aortic aneurysm involving celiac axis with right renal artery reimplantation. Materials and Methods: A 35 year old woman presented with a supra-renal abdominal aortic aneurysm with maximum diameter of 6.7cm. The right renal artery originated from the aneurysm. The left kidney was smaller in size and left renal artery originated from the aneurysm. The aneurysm was repaired with a 18mm dacron tube graft. A patch containing the celiac axis was and re-anastomosed to the Dacron tube. The right renal artery was re-implanted into the tube graft separately. The total clamp time taken for all the anastomosis was 45 minutes including the total time of 35minutes for renal and mesenteric ischemia. Results: Patient had post-operative acidosis, hypothermia and transient rise in renal parameters and could be extubated on second post-operative day i.e. 48 hours after surgery. Postoperative renal Doppler showed good flow across right renal artery atnd left renal artery, without renal infarct. Patient was discharged with normal renal parametres on tenth post-operative day. patency. Conclusion: We conclude that renal artery reimplantation on supra-coeliac clamping of aorta is feasible during supra-renal abdominal aortic artery aneurysm repair with minimum morbidity and excellent