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High-output cardiac failure secondary to a post-traumatic iliocaval fistula

Chighaly El Hadj Sidi1, Imen Mgarrech1, AmineTarmiz1

  • 1Department of Cardiovascular and thoracic surgery, Sahloul University Hospital, 11 Samarkand Street, Ezzahraa, Bouhsina, 4002 Sousse, Tunisia.

Indian Journal of Thoracic and Cardiovascular Surgery
|October 16, 2020
PubMed

Insights

A penetrating injury led to a rare arteriovenous fistula, causing congestive heart failure. Surgical repair successfully excluded the shunt, resolving the patient's symptoms.

Area of Science:

  • Vascular Surgery
  • Cardiology
  • Trauma Surgery

Background:

  • A 24-year-old male presented with progressive congestive heart failure.
  • History of exploratory laparotomy for a penetrating hypogastric wound three years prior.

Observation:

  • Transthoracic echocardiography revealed right heart chamber dilatation.
  • Computed tomography (CT) angiography demonstrated a wide arteriovenous fistula between the right common iliac artery and the iliocaval confluence.
  • Inferior vena cava dilatation was also noted.

Findings:

  • The arteriovenous fistula caused significant hemodynamic changes, leading to heart failure.
  • Surgical intervention involved ligation of the right common iliac artery and aortoiliac bypass.

Implications:

  • Successful surgical exclusion of the arteriovenous fistula resolved the congestive heart failure.
  • Highlights the importance of considering delayed complications of penetrating trauma.
  • Emphasizes the role of advanced imaging in diagnosing complex vascular injuries.

Keywords:
Endovascular repairHigh-output cardiac failureIliocaval fistulaVascular surgery

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