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Arteriovenous fistulas after cardiac catheterization
R L Glaser1, D McKellar, K S Scher
1Department of Surgery, Wright State University School of Medicine, Dayton, Ohio.
Archives of Surgery (Chicago, Ill. : 1960)
|November 1, 1989
Summary
Acquired arteriovenous (A-V) fistulas are a rare complication of cardiac catheterization, occurring in 0.017% of procedures. Prompt surgical intervention is recommended for these fistulas, as spontaneous closure is unlikely.
Area of Science:
- Cardiology
- Vascular Surgery
- Interventional Radiology
Background:
- Acquired arteriovenous (A-V) fistulas are a rare but serious complication following cardiac catheterization.
- These fistulas can lead to significant morbidity, including congestive heart failure and limb ischemia.
Purpose of the Study:
- To determine the incidence and characteristics of acquired arteriovenous fistulas after cardiac catheterization.
- To review the management and outcomes of patients with these fistulas.
Main Methods:
- Retrospective review of seven patients treated for acquired A-V fistulas post-cardiac catheterization over a six-year period.
- Analysis of hospital records to identify fistula incidence, causes, presenting symptoms, and treatment outcomes.
Main Results:
- The incidence of A-V fistulas after 23,291 cardiac catheterizations in Dayton hospitals was 0.017%.
- Common causes included intentional puncture of adjacent artery and vein or inadvertent injury during percutaneous vascular access.
- Congestive heart failure and limb ischemia were the most frequent presenting symptoms, occurring 2-10 months post-procedure.
Conclusions:
- Acquired A-V fistulas are an uncommon complication of cardiac catheterization requiring prompt surgical correction.
- Surgical management, typically involving fistula division and vessel repair, is effective.
- Spontaneous closure of these fistulas is unlikely, necessitating timely intervention.