[Congenital malformations of the abdominal aorta].

Thirty-four patients with a congenital malformation of the abdominal aorta were observed from 1970 to 2002. Thirty-two patients had associated lesions of the renal artery (ies) and 13 had lesions of the splanchnic arteries. Arterial hypertension was present in 32 patients, and two patients had intermittent claudication in the lower limbs. Two sudden deaths occurred before surgery was undertaken. The 32 other patients were operated on. Aortic bypass was performed in 10 patients. The lesions of the renal artery (47 kidneys at risk) were treated by nephrectomy in two cases and vascular repair in 45 cases. Six reconstructions of the superior mesenteric artery were carried out during the same procedure. There were no postoperative deaths. After surgery, arterial hypertension was cured in 74% of the patients, improved in 23% and unchanged in 3%. The intermittent claudication disappeared after aortic bypass in the two patients concerned. In four patients, deterioration of the renal artery repair led to repeat surgery. All aortic reconstructions remained patent, and no late anatomic deterioration occurred. Surgical treatment of renal artery lesions is necessary in most patients. Aortic repair should be reserved for tight stenoses and should be done as close as possible to the end of the growth phase.