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Iatrogenic Arteriovenous Fistula Secondary to Percutaneous Coronary Intervention Causing Severe Decompensated Heart

Nimit Kasliwal1, Wilson B Pfeiffer2, John F Eidt3

  • 1Department of Anesthesiology, Texas A&M College of Medicine, Dallas, USA.

Cureus
|September 22, 2022
PubMed

Insights

An iatrogenic arteriovenous fistula (AV fistula) caused severe heart failure. Surgical ligation successfully treated this rare cause of decompensated heart failure.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Congestive heart failure (CHF) is a significant cause of global morbidity and mortality.
  • Common causes include hypertension, coronary artery disease, alcohol abuse, valvular dysfunction, and myocarditis.
  • Idiopathic cases and rare etiologies like arteriovenous fistulas (AV fistulas) are less understood.

Observation:

  • A rare case of severe decompensated heart failure was observed.
  • The cause was identified as an iatrogenic AV fistula, a complication of percutaneous coronary intervention.
  • This fistula led to systemic consequences including pulmonary edema and end-organ hypoperfusion.

Findings:

  • The iatrogenic AV fistula was confirmed as the etiology of the severe heart failure.
  • Successful treatment was achieved through surgical ligation of the AV fistula.
  • This highlights AV fistulas as a treatable, albeit rare, cause of heart failure.

Implications:

  • Recognizing iatrogenic AV fistulas is crucial for diagnosing unexplained heart failure.
  • Surgical intervention can effectively manage heart failure caused by AV fistulas.
  • Further research into rare cardiac etiologies can improve patient outcomes.

Keywords:
arteriovenous fistula stentheart failurehigh svo2iatrogenic arteriovenous fistulasevere coronary artery disease

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