Use of the thoracic aorta for renal arterial reconstruction.

Abstract

Thoracic aortorenal bypass is a new technique for surgical renal revascularization in patients with severe atherosclerosis of the abdominal aorta. In such cases, the thoracic aorta is often free of disease. From 1989 to 1992, thoracic aortorenal bypass was performed in 23 patients with hypertension, abdominal aortic atherosclerosis, and celiac artery stenosis; in 21 patients, renal artery stenosis was present bilaterally or in a solitary kidney. There was one operative death. Among the remaining 22 patients, hypertension was cured or improved after operation in 19 (86%), and renal function was improved or stable in 21 (95%). Thoracic aortorenal bypass has several advantages and is a useful alternative to abdominal aortic replacement in selected older patients who require renal arterial reconstruction.