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Anatolian Journal of Cardiology Jul 2017
Review
Topics: Adolescent; Arteriovenous Fistula; Coronary Sinus; Coronary Vessel Anomalies; Diagnosis, Differential; Humans; Male; Syncope; Video Recording
PubMed: 28680015
DOI: 10.14744/AnatolJCardiol.2017.7868 -
Annals of Cardiac Anaesthesia 2023Although rare, iatrogenic aortocoronary arteriovenous fistulae (ACAVF) occur when a coronary graft is mistakenly anastomosed to an epicardial vein rather than its...
Resisting arrest: Perioperative confirmation and management of an iatrogenic aortocoronary arteriovenous fistula after coronary artery bypass grafting for redo cardiac surgery.
Although rare, iatrogenic aortocoronary arteriovenous fistulae (ACAVF) occur when a coronary graft is mistakenly anastomosed to an epicardial vein rather than its intended arterial target. Patients may be asymptomatic, demonstrate angina, dyspnea, arrhythmias, syncope, or diminished exercise capacity, and may have wide pulse pressures with evidence of coronary steal. A thorough insight into the disordered anatomy is critical to safely manage a patient for redo cardiac surgery, especially when attempting to arrest the heart. We present a case for redo cardiac surgery of an iatrogenic ACAVF confirmed perioperatively with multiple modalities and its intraoperative management.
Topics: Humans; Cardiac Surgical Procedures; Coronary Artery Bypass; Heart; Angina Pectoris; Arteriovenous Fistula
PubMed: 36722593
DOI: 10.4103/aca.aca_310_20 -
Turkish Neurosurgery 2018Spinal cord arteriovenous fistulas are rare cause of progressive myelopathy. The predictive factors of their outcome after endovascular or surgical treatment are still...
AIM
Spinal cord arteriovenous fistulas are rare cause of progressive myelopathy. The predictive factors of their outcome after endovascular or surgical treatment are still controversial.
MATERIAL AND METHODS
Twenty patients were diagnosed with spinal arteriovenous fistulas; 13 of them had dural and 7 had perimedullary fistulas (1 Dorsal and 6 Ventral). Surgery, endovascular or both treatments were used.
RESULTS
Ten of the 13 patients in the dural group were surgically treated, while 2 were managed by embolization and one combined. Seven patients improved, while 6 patients showed stationary clinical course after intervention. Five patients in the perimedullary group were embolized with clinical improvement, 1 patient refused intervention, and 1 patient had surgery. Clinical improvement was significantly correlated to the duration of symptoms before intervention (p=0.012), and preoperative neurological condition (p=0.001). No significant correlation was found with age, anatomic level of the fistula, fistula type, and type of intervention.
CONCLUSION
Microsurgery was preferred for dural and dorsally located perimedullary fistula, while embolization was preferred for ventrally located ones. Clinical improvement was significantly correlated with early intervention and preoperative neurological condition of the patient. Age of the patient, fistula type, fistula location, and type of intervention did not show significant relation to the outcome. Patients could benefit from intervention even if they present with poor neurological condition.
Topics: Aged; Arteriovenous Fistula; Cohort Studies; Disease Management; Embolization, Therapeutic; Female; Follow-Up Studies; Humans; Male; Microsurgery; Middle Aged; Predictive Value of Tests; Spinal Cord
PubMed: 27593843
DOI: 10.5137/1019-5149.JTN.18009-16.2 -
Arquivos Brasileiros de Cardiologia Sep 2001We report the case of a 3-year-old female patient, who, since birth, had cyanosis difficult to explain with usual diagnostic tests. The only findings on physical... (Review)
Review
We report the case of a 3-year-old female patient, who, since birth, had cyanosis difficult to explain with usual diagnostic tests. The only findings on physical examination were cyanosis and clubbing of her fingers. Chest computerized tomography showed images of excessive attenuation in the right lung, which resembled arteriovenous fistulae that were later confirmed on cardiac catheterization. The fistulous trajectories were then embolized with 7 Gianturco coils, which resulted in an immediate increase in the arterial saturation of blood oxygen.
Topics: Arteriovenous Fistula; Child, Preschool; Cyanosis; Embolization, Therapeutic; Female; Humans; Pulmonary Artery; Pulmonary Veins
PubMed: 11562690
DOI: 10.1590/s0066-782x2001000900008 -
European Journal of Vascular and... Mar 2022
Topics: Arteriovenous Fistula; Fatigue; Femoral Artery; Femur; Humans; Vertigo
PubMed: 34916112
DOI: 10.1016/j.ejvs.2021.10.059 -
ESC Heart Failure Jun 2024
Topics: Humans; Heart Failure; Hemodynamics; Cardiac Output, High; Arteriovenous Shunt, Surgical; Arteriovenous Fistula
PubMed: 38424001
DOI: 10.1002/ehf2.14735 -
Journal of Vascular Surgery Apr 2005An 18-year-old soldier had a gunshot wound to his left thigh during the Mexican Civil War (1910-1917). He presented with persistent bright red bleeding. His wound was...
An 18-year-old soldier had a gunshot wound to his left thigh during the Mexican Civil War (1910-1917). He presented with persistent bright red bleeding. His wound was treated by compression. A few years after the injury, he noticed a thrill, large varicose veins, limb swelling, and skin changes. A plain film showed an 8 x 10-cm midthigh mass. After a bullfighting incident, the pseudoaneurysm ruptured. Because of increased bulk and discomfort, the patient agreed 3 years later to be treated. Angiography showed a chronically obstructed femoral artery and vein. A 3000-mL hematoma was evacuated. This case illustrates the long-term sequelae of an arteriovenous fistula. This report describes a 51-year delay of treatment for causes unrelated to diagnosis. To our knowledge, this case is the longest delay in treatment of an arteriovenous fistula and its complications reported in the literature.
Topics: Adolescent; Arteriovenous Fistula; Humans; Male; Mexico; Time Factors; Treatment Refusal; Warfare; Wounds, Gunshot
PubMed: 15874939
DOI: 10.1016/j.jvs.2005.01.049 -
Journal of Vascular Surgery Jul 2013The goal of this research was to compare side-to-side (STS) and end-to-side (ETS) anastomoses in a computer model of the arteriovenous fistula with computational fluid... (Comparative Study)
Comparative Study
OBJECTIVE
The goal of this research was to compare side-to-side (STS) and end-to-side (ETS) anastomoses in a computer model of the arteriovenous fistula with computational fluid dynamic analysis.
METHODS
A matrix of 17 computer arteriovenous fistula models (SolidWorks, Dassault Systèmes, France) of artery-vein pairs (3-mm-diameter artery + 3-mm-diameter vein and 4-mm-diameter artery +6-mm-diameter vein elliptical anastomoses) in STS, 45° ETS, and 90° ETS configurations with cross-sectional areas (CSAs) of 3.5 to 18.8 mm(2) were evaluated with computational fluid dynamic software (STAR-CCM+; CD-adapco, Melville, NY) in simulations at defined flow rates from 600 to 1200 mL/min and mean arterial pressures of 50 to 140 mm Hg. Models and configurations were evaluated for pressure drop across the anastomosis, arterial inflow, venous outflow, arterial outflow, velocity vector, and wall shear stress (WSS) profile.
RESULTS
Pressure drop across the anastomosis was inversely proportional to anastomotic CSA and to venous outflow and was proportional to arterial inflow. Pressure drop was greater in 3 + 3 models than in 4 + 6 STS models; 90° ETS configurations had the lowest pressure drops and were nearly identical, whereas 45° ETS configurations had the highest pressure drops. Venous outflow in the 4 + 6 model in STS configurations, evaluated at 100 mm Hg arterial inflow pressure, was 390, 592, 610, and 886 mL/min in anastomotic CSAs of 3.5, 5.3, 7.1, and 18.8 mm(2), respectively, and was similar in 90° ETS (609 and 908 mL/min) and lower in 45° ETS (534 and 562 mL/min) configurations at CSAs of 5.3 and 18.8 mm(2). The mean increase in venous outflow was 69 mL/min (range, -59 to 134) between 3 + 3 and 4 + 6 models at 100 mm Hg arterial inflow. The most uniform WSS profile occurs in STS anastomoses followed by 45° ETS and then 90° ETS anastomoses.
CONCLUSIONS
The STS and 90° ETS anastomoses have high venous outflow and a tendency toward reversed arterial outflow. The 45° ETS anastomosis has reduced venous outflow but resists reversed arterial outflow. The STS anastomosis has more uniform WSS characteristics compared with the 45° and 90° ETS anastomoses.
Topics: Anastomosis, Surgical; Arterial Pressure; Arteriovenous Fistula; Blood Flow Velocity; Computer Simulation; Hemodynamics; Humans; Models, Cardiovascular; Regional Blood Flow; Stress, Mechanical; Vascular Surgical Procedures
PubMed: 23433819
DOI: 10.1016/j.jvs.2012.10.070 -
AJNR. American Journal of Neuroradiology Apr 1997To present the clinical and radiologic features of giant perimedullary arteriovenous fistulas (GAVFs) in 12 consecutive cases and to evaluate the results of endovascular...
PURPOSE
To present the clinical and radiologic features of giant perimedullary arteriovenous fistulas (GAVFs) in 12 consecutive cases and to evaluate the results of endovascular treatment.
METHODS
We retrospectively reviewed the clinical and radiologic data as well as the results of balloon endovascular treatment obtained from 1980 to 1989.
RESULTS
GAVFs, defined as large intradural perimedullary direct arteriovenous high-flow shunts, are revealed mainly in childhood either by subarachnoid hemorrhage or by progressive neurologic disorders. MR imaging and myelography show major vascular dilatations. The angioarchitecture of GAVFs can only be assessed by selective spinal angiography. Ten patients were treated by balloon occlusion resulting in eight anatomic cures and six good clinical results. One balloon migrated to the venous side, leading to clinical deterioration.
CONCLUSION
GAVF is a special subgroup of intradural perimedullary arteriovenous fistula. The endovascular approach should be the first line of treatment, with surgery reserved for special circumstances. Nondetachable balloon occlusion is a safe and efficient method for treating GAVFs.
Topics: Adult; Angiography; Arteriovenous Fistula; Child; Child, Preschool; Embolization, Therapeutic; Female; Foreign-Body Migration; Humans; Infant; Magnetic Resonance Imaging; Male; Myelography; Paralysis; Paresis; Retrospective Studies; Safety; Spinal Cord; Subarachnoid Hemorrhage; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 9127029
DOI: No ID Found -
EuroIntervention : Journal of EuroPCR... May 2016Pulmonary arteriovenous malformations (PAVM) describe a broad group of complex vascular malformations, often associated with multi-system diseases and with palliated...
Pulmonary arteriovenous malformations (PAVM) describe a broad group of complex vascular malformations, often associated with multi-system diseases and with palliated complex congenital heart disease. They can have major clinical consequences, resulting in strokes, cerebral abscesses, cyanosis and, infrequently, rupture into the pleural space. The best approach to their investigation and interventional treatment is via a multidisciplinary pathway which should be focused in high-volume centres with on-site thoracic and cardiovascular surgical back-up. The availability of computed tomography (CT) and a broad cathlab inventory aid procedural planning and success. The results of interventional treatment are very encouraging and are applicable to an increasingly broad group of patients thanks to improvements in interventional techniques and a significant expansion of the inventory of vascular occlusion devices.
Topics: Arteriovenous Fistula; Endovascular Procedures; Humans; Pulmonary Artery; Pulmonary Veins
PubMed: 27174107
DOI: 10.4244/EIJV12SXA5