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

Abstract

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.