title: High-output heart failure caused by arteriovenous fistula long after nephrectomy.
abstract: 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.
authors.affiliation: 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
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ozaki
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kubo
authors.forename: Naoji
authors.initials: N
authors.lastname: Hanayama
authors.forename: Katsuharu
authors.initials: K
authors.lastname: Hatada
authors.forename: Hisahito
authors.initials: H
authors.lastname: Shinagawa
authors.forename: Satoru
authors.initials: S
authors.lastname: Maeba
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hirata
authors.forename: Takanao
authors.initials: T
authors.lastname: Aoki
authors.forename: Makoto
authors.initials: M
authors.lastname: Kodama
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: 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