The Right Extra-peritoneal Approach to Abdominal Aortic Aneurysm Associated with Horseshoe Kidney and Left Sided Inferior Vena Cava

A clinical course of a 71-year-old man with AAA and coexistent HSK and LIVC is reported. A right extra-peritoneal exposure was performed and the whole aortoiliac system was seen directly. LIVC was placed posteriorly to AAA. The Y-Graft (UBE SHIELD GRAFT 22× 11) replace- ment was easily replaced without resection of the isthmus of HSK. The aberrant renal artery was reimplanted to the Graft. To our knowledge, this report is the second case of AAA repaired in a patient with the coexistence of HSK and LIVC. (Jpn. J. Vasc. Surg., 12: 545-547 2003)