Abdominal aortic surgery and horseshoe kidney.

Seventy cases, including the six reported here, of aortic operations in patients with horseshoe kidney were reviewed. Anomalous renal arteries were encountered in 42 (60%) of these patients. We concluded that accurate preoperative diagnosis and angiographic delineation of aberrant renal arteries facilitate preservation of renal blood supply. When accessory or anomalous arteries cannot be preserved in situ, they should be reimplanted into the aortic prosthesis. Symphysiotomy may improve operative exposure and when necessary is a safe maneuver.