The aetiology of cardiac arrest in patients undergoing surgical closure of an acute aorto-caval fistula.
Cardiac arrest during the repair of a leaking aortic aneurysm is a well recognized complication of an unsuspected aorto-caval fistula. Previous reports have suggested that death results from embolisation of debris through the fistula. We report a patient who underwent successful resuscitation in whom the sudden alteration in haemodynamics produced by crossclamping the aorta appeared responsible for the development of ventricular fibrillation. Preliminary caval compression with gradual application of the aortic clamp may allow time for equilibration to occur and prevent cardiac arrest.
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D001164:Arteriovenous Fistula / Q000150:complications* / Q000601:surgery; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D008297:Male; D014682:Vena Cava, Inferior / Q000601:surgery