title: Remission of high-output heart failure after surgical repair of 30-month arteriovenous femoral fistula: case report.
abstract: We present a 15-year-old male patient who was admitted to our hospital because of breathlessness and palpitations at minimal physical effort (New York Heart Association class II). The patient had a history of an abdominal and left thigh firearm wound that was surgically treated 30 months earlier. Auscultation over the left femoral groin region revealed a systolodiastolic murmur. X-ray examination of the chest demonstrated significant cardiomegaly. Transthoracic echocardiography revealed an enlargement of 4 cardiac chambers, as well as significant mitral and tricuspid regurgitation. Vascular ultrasound of the femoral artery and vein confirmed the diagnosis of a traumatic arteriovenous fistula. The patient underwent surgical correction of the fistula, after which the symptoms subsided rapidly. Follow-up echocardiography performed 2 months after surgical repair showed a substantial reduction of cardiac size and a nearly complete absence of valvular regurgitations. This case highlights the importance of the recognition of arteriovenous fistulas as a cause of unexpected heart failure and demonstrates that the condition may improve substantially and rapidly after fistula correction.
authors.affiliation: Internal Medicine Clinic, University Clinical Centre, Prishtina, Kosovo. ganibajraktari@yahoo.co.uk
authors.forename: Gani
authors.initials: G
authors.lastname: Bajraktari
authors.forename: Nehat
authors.initials: N
authors.lastname: Rexhepaj
authors.forename: Aurora
authors.initials: A
authors.lastname: Bakalli
authors.forename: Gazmend
authors.initials: G
authors.lastname: Shaqiri
authors.forename: Eshref
authors.initials: E
authors.lastname: Osmani
authors.forename: Lulzim
authors.initials: L
authors.lastname: Vokrri
authors.forename: Shpend
authors.initials: S
authors.lastname: Elezi
mesh_terms: D000293:Adolescent; D001164:Arteriovenous Fistula / Q000150:complications* / Q000209:etiology* / Q000601:surgery; D016534:Cardiac Output, High / Q000209:etiology*; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000209:etiology; D004452:Echocardiography; D005263:Femoral Artery; D005268:Femoral Vein; D006801:Humans; D008297:Male; D012074:Remission Induction; D013616:Tachycardia, Sinus / Q000000981:diagnostic imaging / Q000209:etiology; D014656:Vascular Surgical Procedures; D014948:Wounds, Gunshot / Q000150:complications*