Coronary artery bypass grafting and abdominal aortic aneurysm (AAA) repair were performed in a 59-year-old male patient with horseshoe kidney (HSK). An abdominal mass was detected on physical examination. Ultrasonography revealed a partially thrombosed AAA with a length of 14 cm and a diameter of 6.5 cm. Computed tomography showed a coexistent HSK and the infrarenal location of the AAA ending at the aortic bifurcation. On magnetic resonance angiography, the renal veins were patent and the presence, size, and location of the aneurysm were confirmed. Coronary angiography revealed severe lesions in the left anterior descending artery and the right coronary artery. Renal functions were within normal limits. He was operated on for coronary artery disease with the off-pump technique, followed by a subsequent operation for AAA repair through a median incision. The renal isthmus was preserved and mobilized, providing good access to the aneurysm. A tubular graft was implanted and wrapped by the native aorta. The patient was discharged with no postoperative complications.

Keywords : Aortic aneurysm, abdominal/surgery; coronary artery bypass/methods; kidney/abnormalities; renal artery/abnormalities/ surgery