Technical consideration in management of XXXX in an infant with double renal arteries.

@entity8 @entity101 @entity254 @entity2792 @entity916 @entity850
@entity2792 is a curable disease that has recently been recognized with increasing frequency. A renal scan in a 1-month-old @entity101 white male showed diminished function of the right kidney, and his peripheral vein @entity916 was elevated. Multiple antihypertensive medications failed to control his @entity101 , and right kidney function deteriorated. An arteriogram showed two stenotic renal arteries supplying the right kidney. The smaller inferior artery supplied 35% of the kidney. Selective vein @entity916 levels were greater than 15,000 ng/dL on the right side. Technical considerations in the repair of this lesion included midline transabdominal incision to expose the abdominal aorta and the inferior vena cava; dissection of inferior vena cava (IVC) with division of selected lumbar veins; full mobilization of right kidney and transsection of both @entity8 with cold Sach's solution after resection of arterial stenoses; end-to-side microvascular @entity254 of the smaller (2 mm) renal artery to the main renal artery at the hilum with 10-0 nylon over in situ perfusion cannula; renal artery passed under the IVC to the aorta; and right kidney autotransplanted to a new site on the abdominal aorta with an end-to-side (5.0 mm) renal artery to the aorta and an end-to-side renal vein to IVC @entity254 . Following revascularization, perfusion was excellent and the blood pressure returned to normal. At 6 months follow-up, selective renal vein renins were normal and an arteriogram showed no @entity850 . Meticulous dissection, cold perfusion, microvascular @entity254 , and autotransplantation salvaged this kidney and resolved the @entity101 .
