Kumar Sundeep, Mogalapalli Akhil, Milunski Mark R
Cardiovascular Disease, Saint Louis University Hospital, St. Louis, USA.
Internal Medicine, University of Central Florida College of Medicine, Orlando, USA.
Cureus. 2021 Feb 24;13(2):e13528. doi: 10.7759/cureus.13528.
Iatrogenic aortocaval fistula (ACF) is an infrequent cause of heart failure. A 65-year-old man presented to the cardiology clinic eight months after an open abdominal aortic aneurysm (AAA) repair. He developed predominantly right-sided cardiac failure after surgery, with minimal response to guideline-directed medical therapy. A transthoracic echocardiogram revealed decreased right-sided systolic function. A computed tomography angiographic scan of the abdomen revealed a large ACF at the distal end of the AAA repair. The patient was referred for closure surgery. ACF should be considered in a patient with unexplained right heart failure, especially in the setting of a known AAA or recent AAA repair.
医源性主动脉腔静脉瘘（ACF）是心力衰竭的罕见病因。一名65岁男性在接受开放性腹主动脉瘤（AAA）修复术后8个月就诊于心脏病诊所。术后他主要出现右侧心力衰竭，对指南指导的药物治疗反应甚微。经胸超声心动图显示右侧收缩功能减退。腹部计算机断层血管造影扫描显示在AAA修复远端有一个大的ACF。该患者被转诊进行闭合手术。对于不明原因的右心衰竭患者，尤其是在已知AAA或近期进行过AAA修复的情况下，应考虑ACF。
