A 5.9 cm. abdominal aortic aneurysm in a 59 year old man with right-crossed fused renal ectopia was repaired utilizing a retroperi-toneal throacoabdominal approach, intraoperative renal cooling and implantation of the two renal arteries arising from the aneu-rysm. Color flow renal duplex scanning eight months postopera-tively confirms patency of the renal arteries.