KMID : 0191120160310122051
|
|
Journal of Korean Medical Science 2016 Volume.31 No. 12 p.2051 ~ p.2053
|
|
Delayed High Output Heart Failure due to Arteriovenous Fistula Complicated with Herniated Disc Surgery
|
|
Park Tae-Shik
Park Sang-Ho Arora Alok
|
|
Abstract
|
|
|
A 36-year-old male presented with progressive exertional dyspnea over months. Physical examination showed jugular venous distension, lung crecipitations, femoral bruit and pitting pedal edema. Echocardiogram showed a dilated right ventricle with severe pulmonary hypertension and a non collapsing inferior vena cava (IVC). On right heart catheterization, IVC oxygen saturation was noted at 92% suggesting arterial mixing; a computed tomography of the abdomen showed a fistula between the right common iliac artery to the right common iliac vein at L4 level and a massive IVC; this was linked to trauma from a disectomy done 16 years ago at L4?L5 level. Endovascular sealing with a 16 ¡¿ 60 mm bifurcated stent graft (S & G Biotech, Seoul, Korea) was performed which led to complete resolution of the patient¡¯s dyspnea. Iatrogenic vascular injury during lumbar disc surgery, although rare, can lead to high output cardiac failure developing over months to years.
|
|
KEYWORD
|
|
Arteriovenous Fistula, Herniated Disc Surgery, High Output Cardiac Failure, Endovascular Stent Graft
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|