Transient Division of the Left Renal Vein as Adjunct to Perirenal Aortic Surgery

In perirenal aortic surgery, a transient division of the left renal vein may be necessary in order to expose the perirenal aorta. Perirenal aortic surgery was performed on 4 patients with infrarenal abdominal aortic aneurysms and 1 pa tient with Leriche's syndrome by transection and reanastomosis of the left renal vein. All but 1 of the cases had uneventful postoperative recovery. One of the patients died of septicemia and disseminated intravascular coagulation (DIC) on the fifty-first postoperative day; however, septicemia and DIC were not attrib uted to transient division of the left renal vein.

In all of these cases, the renal function stabilized, and no permanent kidney damage relating to the transient division of the left renal vein could be found.

Although there have been several reports that ligation and division of the left renal vein are a reasonably safe and acceptable procedure for perirenal aortic surgery, the resuturing of the divided left renal vein is recommended. Although this maneuver is simple, it is impossible to determine the adequacy of collateral venous circulation of the left kidney without extensive dissection.