[Surgical experience in arteriovenous fistula following disk surgery]

A 21 year-old woman was admitted to our hospital due to congestive heart failure with severe leg edema. A continuous murmur was heard around the lumbar spine close to a surgical scar after laminectomy of the L4-L5 and L5-S1 disc that the patient had undergone six months before. Aortography demonstrated an arteriovenous fistula between the right common iliac artery and the inferior vena cava. At operation, we found the moderate sized venous defect and it corresponded with the angiographic finding. It was repaired by direct suture from inner side of the right common iliac artery. Arterial reconstruction was made with a 8mm woven dacron graft. Postoperative course was uneventful. The cardiac silhouette diminished in size and cardiac output improved from 12.5l/min. to 8l/min. after surgery. This report is the fourth case of successful repair for the arteriovenous fistula after disc surgery in Japan.