Postrenal biopsy AVM leading to severe hypertension and dilated cardiomyopathy

Area of Science:

• Cardiology
• Nephrology
• Interventional Radiology

Background:

• Alport syndrome can lead to significant renal and cardiovascular complications.
• Hypertension-induced cardiomyopathy is a serious condition, particularly in pediatric patients.
• Renal arteriovenous fistulas (AVFs) are rare but can have severe systemic consequences.

Observation:

• A 3-year-old girl with Alport syndrome presented with decompensated heart failure.
• The heart failure was attributed to hypertension-induced cardiomyopathy, occurring 6 months post-renal biopsy.
• Renal angiography identified a large left renal arteriovenous fistula (AVF) causing poor kidney perfusion.

Findings:

• Transcatheter embolization using an Amplatzer vascular plug successfully treated the left renal AVF.
• Following embolization, the patient's blood pressure normalized.
• Cardiac function improved and normalized within 4 months post-procedure.

Implications:

• Transcatheter embolization is an effective treatment for renal AVFs causing severe complications.
• Prompt intervention can reverse hypertension-induced cardiomyopathy and improve cardiac function.
• This case highlights the importance of investigating vascular complications after renal procedures in patients with underlying conditions like Alport syndrome.