Renal perfusion during complex aortic reconstruction: use of a radial-renal artery shunt.

Use a simple, expedient external shunt between the radial and renal arteries is described in two patients undergoing operation for abdominal aortic aneurysms involving the renal arteries. Such a shunt aided in preservation of postoperative renal function by allowing direct perfusion of the kidney during interruption of renal blood flow. Production of urine by the perfused kidney during clamping documented continued function during the period of renal artery occlusion. Other methods of renal protection during complex aortic reconstructions are discussed. Continuous perfusion of the kidney by means of such a shunt may be especially useful when a prolonged ischemic interval is anticipated, particularly if this involves a solitary kidney or a kidney with already diminished function preoperatively. Use of a larger cannula inserted into the brachial or axillary artery appears to be equally safe and simple and improves flow rates.