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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2001 June;42(3):393-5

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Combined percutaneous and surgical approach to a postnephrectomy arteriovenous fistula

Ferrari M., Bonanomi G., Catalano G., Cioni R., Mosca F.

From the Division of General and Vascular Surgery *Diagnostic and Interventional Radiology University of Pisa, Pisa, Italy


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The ­case of a ­patient ­with ­long-stand­ing ­severe ­heart fail­ure ­that ­was ulti­mate­ly ­found to be sec­on­dary to a ­large com­mu­ni­ca­tion ­between ­the ­right ­renal ­artery ­stump ­and ­the infe­ri­or ­vena ­cava is report­ed. The occur­rence of an arter­i­ov­e­nous fis­tu­la ­should be sus­pect­ed in ­patients ­who under­went pre­vi­ous neph­rec­to­my ­since ear­ly diag­no­sis ­would ­avoid rel­e­vant car­diac com­pli­ca­tions ­and ­the ­demise of a ­patient suf­fer­ing ­from a dis­ease ­that ­may be cor­rect­ed sur­gi­cal­ly or per­cut­ane­ous­ly. We ­describe a com­bined ­approach ­that ­allowed ­the per­cut­ane­ous decom­pres­sion of ­the infe­ri­or ­vena ­cava ­and ­relief of ­the vol­ume over­load to ­the ­heart ­prior to ­the sur­gi­cal liga­tion of ­the arter­i­ov­e­nous fis­tu­la. This ­approach ­should be con­sid­ered a val­u­able ­option ­for treat­ing ­long-stand­ing ­high out­put ­postneph­rec­to­my arter­i­ov­e­nous fis­tu­las.

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