Ten years of experience in the treatment of aorto-mesenteric compression syndrome of the left renal vein and chronic renal phlebohypertension

Authors: Arakelyan V.S.¹, Bukatsello R.G.^1,2, 2, Gidaspov N.A.¹, Kulichkov P.P.¹, Papitashvili V.G.¹, Pryadko S.I.¹, Chshieva I.V.¹, Chernykh N.A.¹

Company: ¹ Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation
² Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation

UDC: 616.146.2:616.61
DOI: https://doi.org/10.24022/1810-0694-2021-22-2-308-317

Cite as: Arakelyan V.S., Bukatsello R.G., Gidaspov N.A., Kulichkov P.P., Papitashvili V.G., Pryadko S.I., Chshieva I.V., Chernykh N.A. Ten years of experience in the treatment of aorto-mesenteric compression syndrome of the left renal vein and chronic renal phlebohypertension. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2021; 22 (2): 308–17 (in Russ.). DOI: 10.24022/1810-0694-2021-22-2-308-317

Received / Accepted: 25.03.2021 / 31.03.2021

Keywords: aorto-mesenteric compression of the renal vein nutcracker syndrome phlebohypertension of the kidney renovascular hypertension chronic pelvic congestion renal vein surgery transposition of the left renal vein

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Abstract

Objective. To evaluate the results of left renal vein (LRV) transposition.

Material and methods. Surgical correction of subvalvular aortic stenosis of 78 patients performed from 2003 to 2016 were analyzed. All patients were divided into 2 groups depending on the length of the obstruction. The first group included 62 patients with a local form of obstruction (membrane form), the second group included 16 patients with an extended form of obstruction (fibromuscular and tunnel form). The following types of operations were performed: membranectomy, myoctomy, Konno operation, Ross–Konno operation, Konno–Rastan operation.

Results. In the early postoperative period, no lethal outcomes or major complications were detected; in 3 (10.3%) cases, retroperitoneal hematomas were verified and treated conservatively. The long-term follow-up period is 38 months (2.5–118 months). The manifestations of chronic pelvic congestion persisted in 33.3% of patients, effective correction of AH was achieved in 85.7% of patients. Restenoses were detected in 13.8% of cases, most of them associated with postoperative hematomas in the plastic area.

Conclusion. LRV transposition is a safe and highly effective treatment option for symptomatic patients. The identified cases of relapse dictate the need for the introduction of alternative treatment options into the clinic and their comparative analysis.

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About the authors

Valeriy S. Arakelyan, Dr. Med. Sc., Professor, Head of Department of Arterial Pathology Surgery; ORCID
Roman G. Bukatsello, Cand. Med. Sc., Senior Researcher; ORCID
Nikita A. Gidaspov, Cand. Med. Sc., Researcher; ORCID
Pavel P. Kulichkov, Cardiovascular Surgeon; ORCID
Vasiliy G. Papitashvili, Cand. Med. Sc., Leading Researcher; ORCID
Sergey I. Pryadko, Cand. Med. Sc., Head of Department of Venous Pathology and Microvascular Surgery; ORCID
Inna V. Chshieva, Cand. Med. Sc., Researcher; ORCID
Nikolay A. Chernykh, Postgraduate; ORCID

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Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

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