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Erschienen in: Pediatric Nephrology 9/2013

01.09.2013 | Brief Report

Aortic bypass and bilateral renal autotransplantation for mid-aortic syndrome

verfasst von: Anna Poupalou, Rémi Salomon, Younes Boudjemline, Emma Allain-Launay, Yves Aigrain, Christophe Chardot

Erschienen in: Pediatric Nephrology | Ausgabe 9/2013

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Abstract

Background

Middle aortic syndrome (MAS) is a rare condition characterized by stenosis of the proximal abdominal aorta and the origin of the renal and digestive arteries. When medical therapy and interventional radiology fail to control threatening reno-vascular arterial hypertension (AHT), surgery is required and may need several interventions, which are usually delayed until late childhood.

Case

We report on a 3-year-old girl with severe AHT (180/130 mmHg) caused by MAS. There was no evidence of generalized vascular disease or complications of AHT. AHT failed to respond to medical therapy (five drugs), endovascular dilatation, and stenting was considered unfeasible due to the complex multiple strictures.
Surgery consisted of: explantation of the two kidneys; aortic bypass between the lower thoracic and lower abdominal aorta using a prosthetic graft; reimplantation of the kidneys onto the normal iliac arteries. The post-operative course was uneventful. Owing to recurrent stenosis of the re-implanted renal arteries, endoluminal dilatations were performed 4 and 5 months after surgery. Two years after surgery, the child is alive and well, off anti-hypertensive therapy, with normal blood pressure.

Conclusion

Mild aortic syndrome can be treated with a one-stage surgical repair with aorto-aortic bypass and bilateral auto-transplantation, even in young children.
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Metadaten
Titel
Aortic bypass and bilateral renal autotransplantation for mid-aortic syndrome
verfasst von
Anna Poupalou
Rémi Salomon
Younes Boudjemline
Emma Allain-Launay
Yves Aigrain
Christophe Chardot
Publikationsdatum
01.09.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 9/2013
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-013-2475-y

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