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Postnephrectomy arteriovenous fistula: a case report.
S Amitani1, K Miyahara, H Miyanohara
1Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Internal Medicine (Tokyo, Japan)
|January 1, 1992
Summary
Severe cardiac failure from a postnephrectomy arteriovenous fistula is rare but treatable. Surgical removal of the fistula resolved the heart failure, highlighting its importance in managing this complication.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Vascular Surgery
Background:
- Arteriovenous fistulas (AVFs) can develop after nephrectomy, a surgical procedure to remove a kidney.
- While rare, these fistulas can lead to severe cardiac complications.
- This case highlights a significant, albeit uncommon, post-nephrectomy complication.
Observation:
- A 57-year-old woman presented with severe cardiac failure.
- The cardiac failure was secondary to an arteriovenous fistula that formed after a nephrectomy.
- A characteristic bruit was noted on auscultation, a common finding in reported cases.
Findings:
- The arteriovenous fistula was successfully treated with surgical intervention.
- The patient's cardiac failure resolved following the fistula removal.
- Literature review indicates only 72 reported cases globally, with 6 from Japan.
Implications:
- Surgical intervention is the primary treatment for post-nephrectomy AV fistulas causing cardiac failure.
- Early diagnosis through careful auscultation for bruits is crucial.
- Percutaneous embolization may be a viable nonsurgical option for small shunts if diagnosed early.