Depboylu Burak Can, Harmandar Buğra, Yazman Serkan, Arslan Kadir
Department of Cardiovascular Surgery, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Oct 23;27(4):586. doi: 10.5606/tgkdc.dergisi.2019.18062. eCollection 2019 Oct.
Coexistence of infrarenal aortic occlusion, known as Leriche syndrome, and horseshoe kidney is extremely rare. The isthmus of the latter, which usually contains functional renal parenchyma, complicates surgery. A 52-year-old male patient with Leriche syndrome and concomitant horseshoe kidney disease underwent a successful surgical repair. A median incision and transperitoneal approach were used to explore the infrarenal aorta, aortoiliac bifurcation, iliac arteries, and horseshoe kidney. The isthmus was connecting the lower poles over the aortoiliac bifurcation. Aortoplasty with aortobifemoral bypass was performed, preserving the horseshoe kidney and its accessory arteries. Operative and postoperative periods were uneventful. At eight months of follow-up, the patient was asymptomatic in daily activities.
肾下主动脉闭塞（即勒里什综合征）与马蹄肾并存极为罕见。马蹄肾的峡部通常含有功能性肾实质，这使手术变得复杂。一名患有勒里什综合征并伴有马蹄肾疾病的52岁男性患者接受了成功的手术修复。采用正中切口和经腹入路来探查肾下主动脉、主动脉髂动脉分叉、髂动脉和马蹄肾。峡部连接着主动脉髂动脉分叉上方的下极。进行了带主动脉双股动脉旁路的主动脉成形术，保留了马蹄肾及其附属动脉。手术期和术后过程均顺利。在随访的八个月时，患者在日常活动中无症状。
