Management of arterio-venous fistula due to unusual aorto-iliac aneurysms.

Aorto-caval fistula associated with thoraco-abdominal aneurysm or with multiple segmental aneurysms is a major challenge for the vascular surgeon. We report two patients who were managed successfully. In addition to the classical surgical techniques of aneurysm repair, we used haemodynamic monitoring with a Swan Ganz catheter, an autotransfusion device and interruption of the vena cava, thus avoiding the three main causes of death in such cases, namely, gross haemodynamic disturbances, major bleeding, and pulmonary embolism.