A Rare Case of Pulmonary Hypertension As a Result of Arteriovenous Fistula After Cardiac Surgery

Abstract

SUMMARYA 19 year-old woman who underwent corrective surgery for an atrial septal defect (ASD) and ventricular septal defect (VSD) 12 years previously presented with pulmonary hypertension. Cardiac catheterization showed a fistula between the right subclavian artery and vena jugularis interna. In this case, a rare example of secondary pulmonary hypertension due to acquired arteriovenous fistula after cardiac surgery is presented. (Int Heart J 2005; 46: 551-556) Key words: Pulmonary hypertension, Arteriovenous fistula SECONDARY pulmonary hypertension is defined as a pulmonary artery systolic pressure higher than 30 mmHg or a pulmonary artery mean pressure higher than 20 mmHg secondary to either a pulmonary or a cardiac disorder. Rarely arteriovenous fistula (AVF) is a cause of pulmonary hypertension.1) An AVF can either be congenital or acquired. Congenital fistulas are a result of a pause in vascular system development.2) Acquired fistulas are usually due to blunt and penetrating traumas. 3,4) In this article, a case of right-sided heart failure associated with pulmonary hypertension due to AVF probably caused by a central venous catheter introduced during repair of atrial septal defect (ASD) and ventricular septal defect (VSD) and late diagnosis with catheterisation is reported. CASE REPORTA 19 year-old woman presented with dyspnea on exertion, fatigue, and lower extremity edema for the preceding 3 months. She had undergone cardiac surgery for repair of ASD and VSD 12 years earlier. Right ventricular failure was suspected and she was hospitalized.From the