From the Department of Medicine, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran.
Abstract: (4448 Views)
Six patients with mitral stenosis complicated by renal artery
embolism studied prospectively are presented. In five patients there was
unilateral and in one patient bilateral renal artery involvement. The
diagnosis was confirmed by intravenous pyelography, retrograde
pyelography, renal angiography, renal scan or a combination of these. All
had atrial fibrillation, proteinuria and elevated LDH levels. Two had
developed hypertension at the initial presentation. All patients were
treated with anticoagulants and other supportive measures. One developed
reversible acute renal failure and the others had an uneventful
hospital course. Subsequent IV.P. and scans revealed nonfunctioning
shrunken kidney in just one patient with complete obstruction of the main
renal artery. We conclude that anticoagulation is an adequate substitute to
embolectomy. The main role of surgery is in occasional patients who
remain anuric despite medical therapy and in those whose angiography
reveals complete occlusion of the main renal artcry.
Type of Study:
case report |
Subject:
General