Emergency gastroduodenal-renal artery bypass. An extra-anatomic approach for salvage of the solitary kidney

A 68-year-old woman had acute anuric renal failure and congestive heart failure. Angiography demonstrated occlusion of the renal artery to the known solitary right kidney and severely ulcerative aortic arteriosclerosis. She underwent an emergency gastroduodenal-renal artery saphenous vein bypass graft with almost immediate restoration of urine output and eventual dramatic improvement in renal function. She remains well two years postoperatively. This is the first report of gastroduodenal-renal bypass performed in the emergency setting for salvage of a solitary kidney.