Arteriovenous Fistula of the Renal Vessels: Surgical Management

Cummings, Kenneth B.; Jolly, Philip C.; Graber, John D.; Burnett, Leland L.

doi:10.1016/s0022-5347(17)67142-8

Cited by 12 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Quantitat ive evaluation o f th e sonography was also attempted. Radioactive scan and renogram supported numerical data of the renal function befo re and after surgery in ou r case (8).…”

Section: Discussionmentioning

confidence: 63%

See 1 more Smart Citation

Arteriovenous Fistula after Partial Nephrectomy - Successful Surgical Repair

Dzsinich¹,

Szabó²,

Dlustus³

et al. 1984

Thorac cardiovasc Surg

View full text Add to dashboard Cite

The postnephrectomy arteriovenous fistula is a very rare condition. There have been 49 cases reported in the world literature to date. Our case is the 50th of this series, and, to our knowledge, the first one following partial nephrectomy. Recurrence of the hypertension after nephrectomy, increasing heart failure, lumbar or upper abdominal bruit are the most characteristic clinical signs suggesting the presence of an arteriovenous communication. The basic diagnostic procedure is angiography. The proper surgical treatment is the separate ligature of the 2 vessels involved.

show abstract

“…Quantitat ive evaluation o f th e sonography was also attempted. Radioactive scan and renogram supported numerical data of the renal function befo re and after surgery in ou r case (8).…”

Section: Discussionmentioning

confidence: 63%

“…A tumor or infection have also been repor ted as the underly ing d isease of renal arteriovenous fist ulae. Rup ture of a fibromuscula r or sclerotic aneurysm of the renal artery into an adjacent vein may produce fistulae (8).…”

Section: Discussionmentioning

confidence: 99%

Arteriovenous Fistula after Partial Nephrectomy - Successful Surgical Repair

Dzsinich¹,

Szabó²,

Dlustus³

et al. 1984

Thorac cardiovasc Surg

View full text Add to dashboard Cite

show abstract

“…Treatment of an arteriovenous fistula consists of primary closure of the artery and vein, and resection of any associated aneurysm (Cummings et al, 1975). When detected, the fistula should be excised before cardiac hypertrophy and failure develop.…”

Section: Discussionmentioning

confidence: 99%

Renal arteriovenous fistula masquerading as severe valvar heart disease.

Glaser¹,

Kramer²,

Hamby³

et al. 1978

Heart

View full text Add to dashboard Cite

SUMMARY Two patients with renal arteriovenous fistulae are described, who presented in high output failure. Murmurs were detected in these patients on routine physical examination years before, and when cardiac failure ensued they were assumed to have decompensated valvar heart disease. Full investigation revealed the arteriovenous fistulae and both patients made a good recovery after surgical ligation.An arteriovenous fistula occurring after abdominal surgery is uncommon and may escape detection, unless the characteristic murmur is sought and angiographic studies performed. We report 2 patients in whom renal arteriovenous fistulae followed nephrectomy and resulted in signs and symptoms consistent with severe valvar heart disease. Case reports CASE 1A 61-year-old woman had a 10-year past history of dyspnoea on exertion. Six years previously a heart murmur had been detected on routine examination.In the following year hypertension was noted, and treatment was started with salt restriction, diuretic, and methyldopa. Four months before admission she developed congestive heart failure and was started on digoxin, but despite this she presented in pulmonary oedema one month later. There was no past history of rheumatism or coronary heart disease, but she had had multiple abdominal surgical procedures, including a right nephrectomy in 1960 for renal tuberculosis and nephrolithiasis.Physical examtion showed a blood pressure of 160/60 mmHg, with a regular pulse of 80 per minute. The carotid upstroke was brisk and full.Lungs were clear. A hyperdynamic apical impulse was palpable in the sixth left intercostal space. A systolic thrill was present, maximal at the lower left sternal border. On auscultation, the first sound was Received for publication 26 January 1978 normal, the second sound narrowly split, and aortic closure slightly accentuated. A harsh grade 3/6 midsystolic murmur was loudest in the second right intercostal space; a grade 4/6 continuous murmur was heard over the entire chest posteriorly loudest over the right costovertebral angle, and in the right upper abdominal quadrant anteriorly where a continuous thrill was present. Loud third and fourth sound gallops were also noted. There was no hepatosplenomegaly. Mild oedema of the ankles was present.The electrocardiogram showed normal sinus rhythm, left atrial abnormality, and increased QRS voltages denoting left ventricular hypertrophy. Chest x-ray films showed cardiomegaly with left ventricular and left atrial enlargement and prominent pulmonary vascular markings.Cardiac catheterisation showed raised right heart pressures. No left or right shunt was detected with the hydrogen electrode. The cardiac output was 10-75 1/min, with cardiac index 6-60 1/min per M2.There was a wide aortic pulse pressure of 120 mmHg. Left ventricular end-diastolic pressure was raised to 32 mmHg. There was no gradient across the aortic valve. Left ventriculogram showed normal contractility with minimal mitral regurgitation. Ascending aortography showed no aortic regurgitation. The co...

show abstract