Hybrid surgery as a new perspective for treatment of abdominal aortic aneurysm associated with a congenital pelvic kidney

The coexistence of an infra-renal abdominal aortic aneurysm (AAA) and a congenital pelvic kidney (CPK) is rare and there are only a few cases reported in literature, mostly treated by conventional open surgery. We present the first report of hybrid surgery as a successful and less invasive treatment for this association. A 75 year-old patient was referred to our department with a 5.7 cm diameter AAA and an ectopic right CPK vascularized by one artery, originated from the anterior wall of the aneurysm in the distal aorta. Treatment consisted in an ilio-renal bypass with autologous saphenous vein by a retroperitoneal approach, followed by the aneurysm endovascular aneurysm repair (EVAR) with an aorto-uni-iliac stent-graft, occlusion of left common iliac artery and ePTFE femoro-femoral crossover bypass. This procedure was simpler and less aggressive than a conventional surgery, with only 6 minutes of renal ischemia, which allowed preservation of the renal function and a faster recovery of the patient.