Salvage of a megafistula causing high-output cardiac failure in a young adult with aneurysmorrhaphy and banding.

Autor:	Goldschmidt E; Department of General Surgery, University of Toledo, Toledo, OH, USA., Schafer K; Department of General Surgery, University of Toledo, Toledo, OH, USA., Hariri N; Promedica, Jobst Vascular Institute, Toledo, OH, USA., Seiwert A; Promedica, Jobst Vascular Institute, Toledo, OH, USA., Lurie F; Promedica, Jobst Vascular Institute, Toledo, OH, USA.
Jazyk:	angličtina
Zdroj:	The journal of vascular access [J Vasc Access] 2023 Jul; Vol. 24 (4), pp. 832-835. Date of Electronic Publication: 2021 Nov 11.
DOI:	10.1177/11297298211055615
Abstrakt:	We present the case of a 21-year-old male with significant lengthening and aneurysmal degeneration of his brachiocephalic arteriovenous fistula resulting in a megafistula and high-output cardiac failure. A computed tomography angiogram showed narrowing at the cephalic arch. Further evaluation during the operation revealed kinking and elongation of the fistula in addition to compression of the cephalic arch in the deltopectoral groove leading to outflow obstruction. The aneurysmal fistula was treated successfully with aneurysmorrhaphy of the remaining conduit and banding of the inflow. This case demonstrates a unique etiology of venous outflow obstruction for a fistula and describes the surgical approach to its treatment in a young patient suffering from cardiac failure. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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