Incidental Pelvic Ectopic Kidney Discovery During Pre-TAVR Imaging: Implications for Surgical Planning

BACKGROUND Renal ectopia (RE) is a congenital malformation in which one or both kidneys fail to reach their normal anatomical position. Most cases are asymptomatic, but they can occasionally lead to complications. This case report presents the incidental finding of a pelvic ectopic kidney during a pre-transcatheter aortic valve replacement (TAVR) evaluation, showing the importance of recognizing anatomical variations in surgical planning for vascular access. CASE REPORT A 68-year-old man undergoing evaluation for severe symptomatic aortic stenosis was incidentally found to have a left pelvic kidney on computed tomography (CT) angiography. The CT scan revealed a dual arterial supply, with one artery entering the kidney medially and an accessory artery wrapping laterally around the kidney, which may have contributed to the failure of its ascent during embryological development. He had no urinary symptoms, and renal function was normal, so no further intervention was required. The identification of this vascular anomaly emphasizes the need for proper preoperative imaging to avoid complications. CONCLUSIONS Recognizing anatomical variations like renal ectopia can help optimize complex vascular procedure planning and prevent complications. Additionally, this case highlights the association between multiple renal arteries and renal ectopia, suggesting further research is needed to understand these correlations.