High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old
Background. Acquired AVF in pediatrics are commonly caused by iatrogenic means, including arterial or venous punctures. These fistulae can cause great hemodynamic stress on the heart as soon as they are created. Case. A six-month-old 25-week gestation infant was referred for respiratory distress. In...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Vascular Medicine |
| Online Access: | http://dx.doi.org/10.1155/2016/8564081 |
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| author | Uygar Teomete Rubee Anne Gugol Holly Neville Ozgur Dandin Ming-Lon Young |
| author_facet | Uygar Teomete Rubee Anne Gugol Holly Neville Ozgur Dandin Ming-Lon Young |
| author_sort | Uygar Teomete |
| collection | DOAJ |
| description | Background. Acquired AVF in pediatrics are commonly caused by iatrogenic means, including arterial or venous punctures. These fistulae can cause great hemodynamic stress on the heart as soon as they are created. Case. A six-month-old 25-week gestation infant was referred for respiratory distress. Initial exam revealed tachypnea, tachycardia, and hypertension. There was a bruit noted on her left arm. An ultrasound showed an arteriovenous fistula. Its location, however, precluded intervention because of the high risk for limb-loss. An echocardiogram showed evidence of pulmonary hypertension that was treated with sildenafil and furosemide. However, no improvement was seen. On temporary manual occlusion of the fistula, the patient was noted to have increased her blood pressure and decreased her heart rate, suggesting significant hemodynamic effect of the fistula. The fistula was subsequently ligated and the patient clinically and echocardiographically improved. Conclusion. A patient in high output cardiac failure or pulmonary artery hypertension, especially prematüre patients with preexisting lung disease, should be probed for history of multiple punctures, trauma, or surgery and should have prompt evaluation for AVF. If it can be diagnosed and repaired, most of the cases have been shown to decrease the stress on the heart and reverse the pathologic hemodynamics. |
| format | Article |
| id | doaj-art-d8ec6047ffee4c70a87235cb31b4aa65 |
| institution | Kabale University |
| issn | 2090-6986 2090-6994 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Vascular Medicine |
| spelling | doaj-art-d8ec6047ffee4c70a87235cb31b4aa652025-08-20T03:24:16ZengWileyCase Reports in Vascular Medicine2090-69862090-69942016-01-01201610.1155/2016/85640818564081High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-OldUygar Teomete0Rubee Anne Gugol1Holly Neville2Ozgur Dandin3Ming-Lon Young4University of Miami Miller School of Medicine, Department of Radiology, Miami, FL 33136, USAUniversity of Miami Miller School of Medicine, Department of Pediatrics, Miami, FL 33136, USADivision of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USAUniversity of Miami Miller School of Medicine, Department of Surgery, Ryder Trauma Center, Miami, FL 33136, USAUniversity of Miami Miller School of Medicine, Department of Pediatrics, Miami, FL 33136, USABackground. Acquired AVF in pediatrics are commonly caused by iatrogenic means, including arterial or venous punctures. These fistulae can cause great hemodynamic stress on the heart as soon as they are created. Case. A six-month-old 25-week gestation infant was referred for respiratory distress. Initial exam revealed tachypnea, tachycardia, and hypertension. There was a bruit noted on her left arm. An ultrasound showed an arteriovenous fistula. Its location, however, precluded intervention because of the high risk for limb-loss. An echocardiogram showed evidence of pulmonary hypertension that was treated with sildenafil and furosemide. However, no improvement was seen. On temporary manual occlusion of the fistula, the patient was noted to have increased her blood pressure and decreased her heart rate, suggesting significant hemodynamic effect of the fistula. The fistula was subsequently ligated and the patient clinically and echocardiographically improved. Conclusion. A patient in high output cardiac failure or pulmonary artery hypertension, especially prematüre patients with preexisting lung disease, should be probed for history of multiple punctures, trauma, or surgery and should have prompt evaluation for AVF. If it can be diagnosed and repaired, most of the cases have been shown to decrease the stress on the heart and reverse the pathologic hemodynamics.http://dx.doi.org/10.1155/2016/8564081 |
| spellingShingle | Uygar Teomete Rubee Anne Gugol Holly Neville Ozgur Dandin Ming-Lon Young High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old Case Reports in Vascular Medicine |
| title | High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old |
| title_full | High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old |
| title_fullStr | High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old |
| title_full_unstemmed | High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old |
| title_short | High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old |
| title_sort | high output cardiac failure resolving after repair of av fistula in a six month old |
| url | http://dx.doi.org/10.1155/2016/8564081 |
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