High-output cardiac failure associated with an iliac artery aneurysm and arteriovenous fistula. A case report.

Rupture of an aneurysm into a major vein is an uncommon complication, and the resulting arteriovenous fistula frequently causes high-output cardiac failure as a presenting symptom. A patient with high-output cardiac failure refractory to conservative treatment and an aortic and left iliac artery aneurysm and associated arteriovenous fistula between the left common iliac artery and vein is presented. The fistula was confirmed by transfemoral arteriography. Successful resection of the aneurysm and closure of the fistula resulted in dramatic clinical improvement. Careful monitoring of cardiovascular function with a Swan-Ganz catheter, before, during and after operation contributed to a satisfactory result.