Congestive Heart Failure Caused by Aortocaval Fistula after Nephrectomy

• Published in: Internal Medicine Vol. 40; no. 11; pp. 1113 - 1116
• Main Authors: OKAMOTO, Mitsunori, HASHIMOTO, Masaki, AKITA, Takako, SUEDA, Takashi, KARAKAWA, Shinji, OHISHI, Yoshihiko, HAMANAKA, Nobuharu
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 2001; Japanese Society of Internal Medicine
• Subjects: Aged; Aortic Diseases - complications; Aortic Diseases - diagnosis; Aortic Diseases - etiology; Aortography; Arteriovenous Fistula - complications; Arteriovenous Fistula - diagnosis; Arteriovenous Fistula - etiology; Arteriovenous Fistula - surgery; Biological and medical sciences; Cardiology. Vascular system; computerized tomography; Female; Heart; Heart Failure - diagnosis; Heart Failure - etiology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Male; Medical sciences; Nephrectomy - adverse effects; Phlebography; renal tuberculosis; Vena Cava, Inferior - diagnostic imaging; Cardiovascular disease; Fistula; Venous disease; Arterial disease; Vascular disease; Nephrectomy; Heart disease; Surgery; Aorta; Complication; Diagnosis; Vena cava; Human; Heart failure; Radiodiagnosis; Instrumentation therapy; Three dimensional field; Long term; Case study; Treatment; Medical imagery; Embolization; Computerized axial tomography; Aortography; Aortic disease
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.40.1113

We treated a 66-year-old man and a 69-year-old woman with high output cardiac failure due to aortocaval fistula. They underwent nephrectomy 40 and 36 years ago, respectively. They suffered from heart failure for a very long time. However, the etiology was not elucidated until recently. The aortogram revealed massive shunt from the aorta to the inferior vena cava via the right renal artery. Three-dimensional computerized tomography clearly delineated the aortocaval fistula. Surgical closure of the fistula promptly improved heart failure. We stress the importance of history taking concerning nephrectomy and the importance of abdominal auscultation in high output cardiac failure. (Internal Medicine 40:1113-1116, 2001)