2007
DOI: 10.1007/s00701-007-1397-5
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High output heart failure due to an iatrogenic arterio-venous fistula after lumbar disc surgery

Abstract: Vascular injury is a rare but not uncommon complication of spinal surgery and associated with dramatic consequences. Congestive heart failure secondary to a hyperkinetic circulation can occur in systemic diseases and in arterio-venous fistulae. A 57-year-old man was admitted to hospital complaining of dyspnoea and oedema of the left leg. Eight days previously he had undergone a discectomy at L4-L5. On auscultation a systolic-diastolic murmur was noted over the entire abdomen. An echocardiogram demonstrated an … Show more

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Cited by 20 publications
(20 citation statements)
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“…The most common injury is a vascular tear, 3 and its presentation varies from heavy bleeding to signs of shock including tachycardia and hypotension in the early postoperative period. [4][5][6][7][9][10][11][12][13]15,18,19,28 Other vascular injuries, such as AVFs and pseudoaneurysms, are commonly diagnosed in the late postoperative period. 2 AVF is the second most common type of vascular injury after lumbar spine surgery 3 and can have various presentations.…”
Section: Discussionmentioning
confidence: 99%
See 2 more Smart Citations
“…The most common injury is a vascular tear, 3 and its presentation varies from heavy bleeding to signs of shock including tachycardia and hypotension in the early postoperative period. [4][5][6][7][9][10][11][12][13]15,18,19,28 Other vascular injuries, such as AVFs and pseudoaneurysms, are commonly diagnosed in the late postoperative period. 2 AVF is the second most common type of vascular injury after lumbar spine surgery 3 and can have various presentations.…”
Section: Discussionmentioning
confidence: 99%
“…The early diagnosis of an AVF is often due to high-output cardiac failure. 11,18,26 Late diagnoses vary in presentation from leg edema, back pain, abdominal bruits, and pulsating masses to high-output cardiac failure. 4,5,9,10,[13][14][15][16][17]25,26 While these symptoms may help lead to a diagnosis, up to 50% of patients with an AVF may be completely asymptomatic.…”
Section: Discussionmentioning
confidence: 99%
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“…In the case of an arterial injury, all alternatives must be utilized to provide the continuity of the vascular structure to protect the extremity. Primary repair, graft interposition, synthetic or saphenous vein patch plasty, or endovascular interventions are the treatment options for arterial injury (3,4,7,9,11,12,13,16,17,18). Primary repair was performed in our two patients, and in one we performed synthetic polytetrafluoroethylene graft interposition for complicated major arterial injury.…”
Section: A B Keskin M Et Al: Iatrogenic Major Vascular Injury Duringmentioning
confidence: 99%
“…Conventional angiography can be used for both diagnostic and therapeutic measures (7,16,17,20). First case was in shock and diagnosed by emergency laparotomy, second one by CT angiography and third one was diagnosed by simply the physical examination.…”
Section: A B Keskin M Et Al: Iatrogenic Major Vascular Injury Duringmentioning
confidence: 99%