Surgical Repair of Aortocaval Fistula Presenting with Cardiogenic Shock

Abstract

Aortocaval fistula (ACF) occurs in <1% of all abdominal aortic aneurysms (AAAs), and in 3% to 7% of all ruptured AAAs. The triad of clinical findings of AAA with ACF are abdominal pain, abdominal machinery bruit, and a pulsating abdominal mass. Other findings include pelvic venous hypertension (hematuria, oliguria, scrotal edema), lower-limb edema with or without arterial insufficiency or venous thrombus, shock, congestive heart failure, and cardiac arrest. Surgery is the main treatment modality. We report successful surgical treatment in a patient with a ruptured AAA with ACF who presented with cardiogenic shock.

Endovascular management of aortocaval fistula complicating abdominal aortic aneurysm presenting as an acute renal failure

“…The clinical signs and symptoms are quit variable that include abdominal pain, venous hypertension, lower-limb edema with or without arterial insufficiency or venous thrombus, shock, congestive heart failure, and cardiac arrest. However, abdominal pain, abdominal machinery bruit, and a pulsating abdominal mass are the classical triad of clinical findings [ 2 ]. Because of the variable clinical manifestations, the diagnosis is often delayed, which increases the difficulties in treatment [ 3 ].…”

“…Abdominal pain, abdominal machinery bruit, and a pulsating abdominal mass are the triad of clinical findings. Other findings include pelvic venous hypertension, lower-limb edema with or without arterial insufficiency or venous thrombus, shock, congestive heart failure, and cardiac arrest [ 2 ]. Because of the variable clinical manifestations, the diagnosis is often delayed, which increases the difficulties in treatment [ 3 ].…”