An unusual cause of high-output heart failure from the iliac arteriovenous fistula after lumbar discectomy: A case report

High Output Heart Failure Due to Iatrogenic Iliac Arteriovenous Fistula

“…The mechanism of injury during LDS is probably direct force from the sharp instrument which passed through the anterior longitudinal ligament at the L4-5 or L5-S1 level, causing the fistula between the common iliac artery and vein. 2 Consequently, high-output HF is often developed during the period from 1 month to 1 year following LDS; therefore, careful history taking and physical examination, including auscultation over the suspicious area, are mandatory. When iliac AVF is suspected, computed tomography or magnetic resonance angiography is performed to confirm the diagnosis and to evaluate its location and size as well as associated complications (eg, pseudoaneurysm).…”