Abstract
Neste trabalho é apresentado um caso de coexistência de aterosclerose aorto-ilíaca com rim em ferradura, em um homem com 57 anos de idade. O diagnóstico desta combinação rara foi feito pouco antes da cirurgia, com a angio-ressonância magnética constituindo o método diagnóstico pré-operatório mais importante para o planejamento cirúrgico. A abordagem transabdominal proporciona uma exposição excelente da aorta abdominal em pacientes com rim em ferradura, sem risco de lesão das artérias renais acessórias ou de ureter em posição anômala. A reconstrução foi feita com a implantação de uma prótese de Dacron em Y em posição aorto-bifemoral e, por causa da lesão aterosclerótica difusa e na presença do rim em ferradura, foi optado por anastomose proximal término-lateral.
Highlights
Horseshoe kidney is the most common urinary tract anomaly the association of this anomaly significantly increases the difficulty of aortic surgery in aortoiliac vascular disease
In most cases aortic surgery has to be performed for abdominal aortic aneurysm and seldom for occlusive diseases [1,2]
As described above concomitance of aortoiliac occlusive disease and horseshoe kidney compared to abdominal aortic aneurysm and horseshoe kidney is very rare
Summary
Horseshoe kidney is the most common urinary tract anomaly the association of this anomaly significantly increases the difficulty of aortic surgery in aortoiliac vascular disease. And for the first time we discuss and present the most accurate preoperative diagnostic method and the optimal surgical approach in aortoiliac occlusive disease associated with a horseshoe kidney. The patient was referred to our department for evaluation of aortoiliac occlusion disease and aortic surgery. He had mild arterial hypertension and smoked 15 cigarettes a day. There was no history of cardiac, cerebral or renal vascular disease On examination, he was generally well, chest and abdomen showed no abnormalities. The postoperative course showed no pathologic events and the patient was discharged on 8th postoperative day
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