High Output Heart Failure 8 Months After an Acquired Arteriovenous Fistula

Abstract

SUMMARYCongestive heart failure (CHF) due to hyperkinetic states can occur in systemic diseases and in arteriovenous fistulas. An 18 year old Turkish male patient complaining of dyspnea and palpitations, who had suffered a stab wound to his abdomen eight months earlier, was admitted to our clinic. Auscultation revealed a systolodiastolic murmur over the entire abdomen. Chest x-rays demonstrated significant cardiomegaly. Echocardiography revealed biatrial enlargement and significant mitral and tricuspid regurgitation accompanied by dilatation of the inferior vena cava. Right heart catheterization showed increased oxygen saturation at the inferior vena cava. A diagnosis of an aortocaval fistula was made by aortography. The symptoms subsided and valvular regurgitations ceased after surgical correction. This rare case demonstrates the significance of routine physical examination and history of the patient. (Jpn Heart J 2003; 44: 805-809)

A case of paraspinal arteriovenous fistula in the lumbar spinal body assessed with time resolved three‐dimensional phase contrast MRI

“…In the case, we had to exclude aortic pseudoaneurysm that is associated with very high mortality if not promptly discovered and urgently treated. In cases with AVF, on the other hand, high output heart failure was the concern rather than hemorrhage (4, 5). The patient actually had a small amount of pleural effusion and ascites due to cardiac volume overload.…”

Transarterial Coil Embolization of an Abdominal Aortocaval Fistula in a Dog

“…Origin, size, localization, and evolution time of the fistula determine the degree of hemodynamic disturbances. The hemodynamic disturbances observed depend on arterial pressure at the site of arteriovenous connection and the velocity of shunting flow 6, 7, 8. Arteriovenous fistulas deviate blood flow from high‐resistance arterial to low‐resistance venous systems and decrease peripheral vascular resistance and pressure inside the aorta, caudal to the fistula 5, 9.…”

“…The hemodynamic disturbances observed depend on arterial pressure at the site of arteriovenous connection and the velocity of shunting flow. [6][7][8] Arteriovenous fistulas deviate blood flow from high-resistance arterial to low-resistance venous systems and decrease peripheral vascular resistance and pressure inside the aorta, caudal to the fistula. 5,9 In addition, changes in blood volume are associated with relatively small changes in venous pressure attributable to the large systemic venous capacitance.…”

Aortocaval fistula delays gastric emptying of liquid test meal in awake rats

“…In addition to causing hyperkinetic circulation, ACF placement delayed the GE of liquid in awake rats, an effect that likely involves a parasympathetic pathway. arteriovenous fistula; gastrointestinal motility; hyperkinetic circulation; intestinal transit; natriuretic hormone HYPERKINETIC CIRCULATION IS a systemic condition that may originate from an arteriovenous (AV) fistula, either as a congenital malformation or acquired after invasive procedures (e.g., percutaneous renal biopsy), surgeries (e.g., nephrectomy), or trauma (e.g., stab or gunshot wounds) (11,24). Large AV fistulas are considered a simple and reliable model to elicit congestive heart failure (13).…”