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Patient has pararenal aortic aneurysm and due to the pararenal extension of the aneurysm and multiple accessory renal arteries, we felt the patient would need renal artery bypasses in addition to repair of his aortic aneurysm. A splenorenal bypass was performed to the mid left renal artery. A superior mesenteric artery to the renal artery bypass was performed to the most inferior left renal artery. This was performed with a ringed 6-mm Propaten bypass graft. Pararenal aortic aneurysm repair was performed with a 20mm x 10mm bifuracated Dacron graft. The right distal anastomosis was to the right common iliac artery and the left distal anastomosis was to the left common femoral artery. We have the following codes: 35091 35631 35636