Reversal of pulmonary hypertension after percutaneous closure of congenital renal arteriovenous fistula in a 74-year old woman. - 2015

Available in print through MWHC library: 2002 - present

We report the case of a large right renal arteriovenous fistula (AVF) in a 74-year old woman who presented with heart failure. Transthoracic echocardiography revealed normal left ventricular size and systolic function (ejection fraction 60-65%), moderately dilated right ventricle with severely depressed systolic function, and severe pulmonary hypertension. Right heart catheterization confirmed the elevated pulmonary pressures and showed a high cardiac output. Physical examination was remarkable for a right flank bruit. An abdominal ultrasound revealed an AVF originating from the distal right renal artery and dilated suprarenal inferior vena cava and hepatic veins. These findings were confirmed with an abdominal MRI. Percutaneous endovascular closure of the right renal AVF was successfully performed, with immediate reduction of pulmonary pressures and normalization of cardiac output. The patient's symptoms improved, and a post intervention echocardiogram revealed normalization of right ventricular size. Copyright © 2015 Elsevier Inc. All rights reserved.


English

1878-0938


*Arteriovenous Fistula/su [Surgery]
*Hypertension, Pulmonary
*Renal Artery/su [Surgery]
*Renal Veins/su [Surgery]
Aged
Arteriovenous Fistula/di [Diagnosis]
Cardiac Catheterization/mt [Methods]
Female
Heart Failure/pp [Physiopathology]
Heart Ventricles/pp [Physiopathology]
Heart Ventricles/su [Surgery]
Humans
Hypertension, Pulmonary/di [Diagnosis]
Hypertension, Pulmonary/et [Etiology]
Hypertension, Pulmonary/pp [Physiopathology]
Treatment Outcome


MedStar Heart & Vascular Institute


Case Reports
Journal Article