title: Heart failure caused by renal arteriovenous fistula with giant renal artery aneurysms.
abstract: We encountered an extremely rare case of a renal arteriovenous fistula (AVF) with 2 giant renal artery aneurysms (RAAs) in a 75-year-old woman who presented with congestive heart failure and pulmonary hypertension. A chest x-ray revealed cardiomegaly with a cardiothoracic ratio (CTR) of 65%. Computed tomography showed 2 giant left RAAs (diameter, 45 × 40 mm(2) and 75 × 60 mm(2)) associated with an AVF, dilated inferior vena cava, and dilated pulmonary arteries. A radical nephrectomy was performed through a transverse laparotomy after the left renal vein, and arteries were dissected from the inferior vena cava and aorta, respectively. The patient's postoperative course was uneventful, and her condition improved. Her cardiomegaly was ameliorated, as manifested by a decrease in CTR to 57% and the absence of volume overload.
authors.affiliation: Department of Cardiovascular Surgery, Tachikawa Medical Center, Niigata, Japan yamanashimedical@yahoo.co.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Department of Cardiovascular Surgery, Tachikawa Medical Center, Niigata, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sugimoto
authors.affiliation: Department of Cardiovascular Surgery, Tachikawa Medical Center, Niigata, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiovascular Surgery, Tachikawa Medical Center, Niigata, Japan.
authors.forename: Shinpei
authors.initials: S
authors.lastname: Yoshii
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D001706:Biopsy; D006332:Cardiomegaly / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D009392:Nephrectomy; D010690:Phlebography / Q000379:methods; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
keywords: heart failure; renal arteriovenous fistula; renal artery aneurysm