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75-Year-Old Woman With Flash Pulmonary Edema, Cardiac Failure, lschemic Nephropathy, Weight Loss, and Claudication: A Case Report

Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic Rochester, Minnesota

Peter Gloviczki, MD

Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Mayo Medical School, Rochester, Minnesota; gloviczki.peter{at}mayo.edu

Marc Coggia, MD

Ambroise Pare University Hospital CHU Pitie-Salpetriere, Paris, France

Fabien Koskas, MD

Vascular Surgery, CHU Pitie-Salpetri6re, Paris, France

Flash pulmonary edema can occur in the face of renal artery stenosis. Although there is a growing trend toward the treatment of renal artery stenosis with percutaneous techniques, this is not feasible in the case of a heavily calcified nearly occluded aorta. In this report, we describe the case of a 76-year-old woman with severe renal, mesenteric, and iliac atherosclerosis. We performed a staged vascular reconstruction by initially placing an axillary-femoralfemoral bypass to unload a severely compromised left ventricle in preparation for aortic clamping for a visceral and renal artery bypass. This type of staged repair may be useful in aortic reconstruction for patients with severely compromised left ventricular ejection fraction.

Key Words: renal artery stenosis • flash pulmonary edema • atherosclerosis

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