9473112

Long-term outcome with surgical treatment of renovascular hypertension. Fibromuscular hyperplasia (FMH) was the main etiology (45 of 53 patients), with 17 of these having midaortic involvement as well. Sex distribution was equal; average age was 9 years. Malignant hypertension was the rule, and three had renal failure. Twenty-three of the 45 had bilateral vessel involvement. Fifty of the 53 patients underwent operation. Aortography was the most definitive approach to diagnosis and planning therapy. Balloon angioplasty was used in eight patients, but this only worked long term in branch vessel locations or at graft anastomoses. A variety of surgical approaches were used depending on the pathology encountered. Thirty-eight patients underwent revascularization, seven underwent primary nephrectomy, five underwent primary partial nephrectomy, and 12 had aortoaortic bypass performed. Seventy percent were cured, 26% improved; and 4% did not respond to treatment with up to 16 years of follow-up. There was no mortality.