Aorto-Caval Fistula: Successful Management of Two Cases

Area of Science:

• Vascular Surgery
• Aneurysm Research
• Cardiovascular Medicine

Background:

• Aorto-caval fistula is a rare complication of aortic aneurysms.
• Spontaneous rupture into the inferior vena cava presents diagnostic and therapeutic challenges.
• Classical signs may not always indicate the severity of the arteriovenous fistula.

Purpose of the Study:

• To describe two cases of aorto-caval fistula secondary to spontaneous aortic aneurysm rupture.
• To highlight the varied clinical presentations and outcomes.
• To discuss the management of associated complications.

Main Methods:

• Case report analysis of two patients with aorto-caval fistula.
• Clinical examination findings including pulsatile mass, thrill, and murmur.
• Review of surgical interventions and patient outcomes.

Main Results:

• Both patients had aorto-caval fistulas from ruptured aortic aneurysms.
• The first patient presented with overt arteriovenous fistula signs and recovered post-operatively.
• The second patient, elderly, survived multiple severe complications including renal failure and suppuration.

Conclusions:

• Aorto-caval fistula requires prompt recognition and management.
• Clinical presentation can vary significantly, even with similar fistula locations.
• Elderly patients may exhibit remarkable resilience despite complex surgical disasters.