High-output heart failure caused by arteriovenous fistula long after nephrectomy.
A 70-year-old Japanese woman was admitted to our hospital because of anasarca. At 32 years of age, she had undergone nephrectomy for renal tuberculosis. A continuous abdominal bruit was heard. The chest X-ray showed cardiomegaly and dilatation of the pulmonary artery. Abdominal three-dimensional computed tomography scanning clearly revealed an arteriovenous fistula. Cardiac catheterization disclosed cardiac output of 9.2 l/min and a step-up of oxygen saturation at the renal vein level of the inferior vena cava. Surgical closure of the fistula promptly decreased her cardiac output and improved the heart failure. This is a rare case of an arteriovenous fistula developing long after nephrectomy and causing high-output heart failure.
Ozaki
Kazuyuki
K
Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi, Niigata 951-8510, Japan. k-ozaki@med.niigata-u.ac.jp
Kubo
Takaaki
T
Hanayama
Naoji
N
Hatada
Katsuharu
K
Shinagawa
Hisahito
H
Maeba
Satoru
S
Hirata
Kazuhiko
K
Aoki
Takanao
T
Kodama
Makoto
M
Aizawa
Yoshifusa
Y
D000368:Aged; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D016534:Cardiac Output, High; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D009392:Nephrectomy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014398:Tuberculosis, Renal / Q000601:surgery