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Secondary cardiac disease due to postnephrectomy arterio-venous fistula. Report of a case and review of literature Hisayasu Ogasawara 1 , Shoji Sakamoto 2 , Toshiyuki Kobayashi 2 , Mitsuo Narusue 2 , Tsuyohi Takahashi 2 , Noboru Miichi 2 , Eiji Sanada 2 , Tomoyoshi Muramatsu 2 , Sigeru Hirota 3 1Department of Cardiovascular Surgery, Fukuyama Municipal Hospital 2Department of Surgery,Fukuyama Municipal Hospital 3Department of Medicine, National Hospital of Fukuyama pp.945-950
Published Date 1985/7/15
DOI https://doi.org/10.11477/mf.1404204717
  • Abstract
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An arteriovenous fistula between the residual stumps of the renal artery and vein is reported in a 52 year old female 20 years following right ne-phrectomy for tuberculosis. The patient presented with the manifestations of high output cardiac fail-ure. The diagnosis was confirmed by retrogradeabdominal aortogram. Hemodynamic studies reveal-ed the profound effects of the fistula on cardiac output, stroke volume, peripheral vascular resistance etc. Ligation of the renal arterial stump resulted in disappearance of the bruit and improvement in symptoms. Three weeks later hemodynamic findings were normal, but hypertension persisted and post-operative ECG demonstrated profoud subendocardi-al ischemia.

In 46 previous reports fistulas were operated five months to thirty-five years postnephrectomy. Slow evolution of cardiac decompensation was noted in 70 per cent ; a bruit was heard in most. The precise etiology of this entity remains obscure although there are several theories as to causation. Surgical corrective approaches vary ; results indicate cure or improvement in most.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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