A rare complication of laparoscopic surgery: iatrogenic arteriovenous fistula with high-output cardiac failure.
The authors report a 19-year-old man with cardiomegaly and high-output cardiac failure resulting from a hemodynamically significant arteriovenous fistula that was diagnosed 18 months after laparoscopic surgery for an inguinal hernia. The diagnosis was established on clinical examination and by ultrasonography and was confirmed by cardiac catheterization and angiography. The fistula was closed surgically by direct venous suture and reconstruction of the iliac artery with a polytetrafluoroethylene patch. The surgical repair achieved complete closure of the fistula with rapid normalization of cardiac size and function within 8 days.
Ovroutski
S
S
Department of Congenital Heart Disease, German Heart Institute, Augustenburger Platz 1, 13533 Berlin, Germany. ovroutski@dhzb.de
Ewert
P
P
Schubel
J
J
Lange
P E
PE
Hetzer
R
R
D000328:Adult; D000792:Angiography; D001164:Arteriovenous Fistula / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006328:Cardiac Catheterization; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007049:Iatrogenic Disease; D007083:Iliac Artery / Q000002:abnormalities; D007084:Iliac Vein / Q000002:abnormalities; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007813:Laparotomy; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler