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Aorto-caval fistula – case report


Authors: K. Houdek;  J. Moláček;  V. Třeška
Authors place of work: Chirurgická klinika, Fakultní nemocnice a Lékařská fakulta v Plzni, Univerzita Karlova
Published in the journal: Rozhl. Chir., 2020, roč. 99, č. 5, s. 236-238.
Category: Case Report
doi: https://doi.org/10.33699/PIS.2019.98.5.236–238

Summary

Aorto-caval fistula can be associated with abdominal aortic aneurysm. The fistula can manifest with nonspecific symptoms. The rupture of abdominal aortic aneurysm is one of the leading symptoms. The symptoms and the necessity of treatment are related to these acute conditions. This article describes the case of a 78 years old man with a huge abdominal aortic aneurysm and aorto-caval fistula that was presented with a sudden onset of abdominal pain, dyspnoea, hypotension and cardiac insufficiency with an acute cor pulmonale. Urgent surgery was performed – aneurysm resection with transaortic suture of the fistula and aortic replacement using a Dacron graft. Resuscitation and defibrillation were needed during the surgery due to fibrillation cardiac arrest, which were successful. The post-operative period was complicated with a persisting consciousness disorder of the patient and persisting myocardial ischaemia, resulting in the patient’s death 3 weeks after the surgery. The aim of this report is to point out the severity of this condition, the various treatment options of this uncommon disease with an uncertain prognosis, and also the importance of a multidisciplinary approach, essential in the entire treatment process as well as in the primary diagnosis.

Keywords:

aorto-caval fistula – stentgraft – open repair


Zdroje
  1. Miani S, Giorgetti PL, Arpesani A, et al. Spontaneous aorto-caval fistulas from rupured abdominal aortic aneurysms. Eur J Vasc Surg. 1994;8(1):36−40. doi: 10.1016/s0950-821x(05)80117-3.
  2. Schmidt R, Bruns C, Walter M, et al. Aorto-caval fistula - an uncommon complication of infrarenal aortic aneurysms. Thorac Cardiovasc Surg. 1994;42(4):208−211. doi: 10.1055/s-2007-1016489.
  3. Potyk DK, Guthrie CR. Spontaneous aortocaval fistula. Ann Emerg Med. 1995;25(3):424−427 D. doi: 10.1016/s0196-0644(95)70305-5.
  4. McKeown BJ, Rankin SC. Aortocaval fistulae presenting with renal failure: CT diagnosis. Clin Radiol. 1994;49(8):570−572. doi: 10.1016/s0009-9260(05)82940-x.
  5. Iriz E, Ozdogan ME, Erer D, et al. A giant aortocaval fistula due to abdominal aortic aneurysm. Int J Cardiol. 2006;10;112(3):e78−e80. doi: 10.1016/j.ijcard.2006.03.075.
  6. Cinara IS, Davidovic LB, Kostic DM, et al. Aorto-caval fistulas: a review of eighteen years experience. Acta Chir Belg. 2005;105(6):616−620. doi: 10.1080/00015458.2008.11679788.
  7. Leigh-Smith S, Smith RC. Aorto caval fistula - the „bursting heart syndrome“. J Accid Emerg Med. 2000;17:223−225. doi:10.1136/emj.17.3.223.
  8. Fujisawa Y, Kurimoto Y, Morishita K, et al. Aortocaval fistula after endovascular stent-grafting of abdominal aortic aneurysm. J Cardiovasc Surg. 2009;50(3).387−389 PMID: 18948877.
  9. Alexander JJ, Imbembo AL. Aorta-vena cava fistula. Surgery 1989;105(1):1−12 PMID: 2643193.
  10. Gedvilas D, Argatu D, Lukosevicius S, et al. Aorto-caval fistula clinically presenting as left renal colic. Findings of mulislice computed tomography. Medicina (Kaunas) 2008;44(8):619−622 PMID:18791339.
  11. Abreo G, Lenihan DJ, Nguyen P, et al. High-output heart failure resulting from a remote traumatic aorto-caval fistula: diagnosis by echocardiography. Clin Cardiol. 2000;23(4):304−306. doi: 10.1002/clc.4960230419.
  12. Davidovic LB, Kostic DM, Cvetkovic SD et al. Aorto-caval fistulas. Cardiovasc Surg. 2002;10(6):555−660. doi:10.1016/s0967-2109(02)22106-0.
  13. Ghilardi G, Scorza R, Bortolani E, et al. Rupture of abdominal aortic aneurysms into the major abdominal veins. J Cardiovasc Surg. 1993;34(1):39−47 PMID: 8482703.
  14. Calligaro KD, Savarese RP, DeLaurentis DA. Unusual aspects of aortovenous fistula associated with ruptured abdominal aortic anuerysms. J Vasc Surg. 1990;12(5):586−590. doi:10.1067/mva.1990.23414.
  15. Mitchel ME, McDaniel HB, Rushton FW. Endovascular repair of a chronic aortocaval fistula using a thoracic aortic endoprosthesis. Ann Vasc Surg. 2009;23(1):150−152. doi:10.1016/j.avsq.2007.10.007.
  16. Liu M, Wang H. Endovascular stent-graft repair of spontaneous aorto-caval fistula secondary to a ruptured abdominal aortic aneurysm: An emergency management of hostile anatomy. SAGE Open Medical Case Reports 2016;18(4):1−4. doi:10.1177-2050313X166.46526.
  17. Rapacciuolo A, DeAngelis MC, di Pietro D, et al. Percutaneous treatment of a aorto-caval fistula in a old high risk patient. BMC Surg. 2012;12 Suppl 1:S32. doi:10.1186/1471-2482-12-S1-S32.
  18. Godart F, Haulon S, Houmany M, et al. Transcatheter closure of aortocaval fistula with teh amplatzer dusct occluder. J Endovasc Ther. 2005;12(1):134−137.doi:10.1583/04-1332.1.
  19. Silveira PG, Cunha JR, Lima GB, et al. Endovascular treatment of ruptured abdominal aortic aneurysm with aortocaval fistula based on aortic and inferior vena cava stent-graft placement. Ann Vasc Surg. 2014;28(8):1933.e1−5. doi:0.1016/j.avsq.2014.06.073.
  20. Melas N, Saratzis A, Saratzis N. Inferior vena cava stent-graft placement to treat endoleak associated with an aortocaval fistula. J Endovasc Ther. 2011;18(2):250−254. doi: 10.1583/10-3296.1.
Štítky
Surgery Orthopaedics Trauma surgery
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