Surgical treatment of renovascular hypertension in children

Abstract

Objectives: The aim of this retrospective study was to report the author's experience of the surgical treatment of renovascular hypertension in children and to define the role of surgery in its treatment.

Material and methods: This series includes 85 patients (50 girls, 35 boys), 28 months to 18 years of age (mean: 10.3) operated on from 1970 to 2005. All patients had arterial hypertension and underwent the investigations usually performed in hypertensive patients. Renal artery lesions were bilateral in 26 cases. Due to bilateral procedures and to secondary or late reoperations, the number of surgical procedures was 114 (15 nephrectomies and 99 arterial repairs).

Results: Fibrodysplasia of the renal artery was the prevailing pathologic factor (71%). Associated vascular lesions were observed in 61% of the patients. There was no postoperative death in this series. Seven postoperative thromboses occurred (7% of the repairs). The complete cure of arterial hypertension was obtained in 82% of the patients. In young children, growth of the repairs was normal when age increased.

Conclusion: Surgery still holds a prominent place in the treatment of renovascular hypertension in children. Its prognosis is favourable since atheroma or organ lesions are usually lacking.