Congestive heart failure due to an iatrogenic arteriovenous fistula in a patient with neurofibromatosis-1.
- Author:
E Ryoung CHOI
1
;
Su Jin LEE
;
Soo Min KIM
;
Hee Jung CHOI
;
Chang Seok KI
;
Yeon Hyeon CHOI
;
Duk Kyung KIM
Author Information
1. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dkkim@skku.edu
- Publication Type:Case Report
- Keywords:
Arteriovenous fistula;
Congestive heart failure;
Neurofibromatosis type 1
- MeSH:
Adult;
Arteriovenous Fistula;
Biopsy;
Cafe-au-Lait Spots;
Consensus Sequence;
Dilatation;
Dyspnea;
Echocardiography;
Estrogens, Conjugated (USP);
Female;
Fistula;
Follow-Up Studies;
Heart;
Heart Atria;
Heart Failure;
Heart Ventricles;
Humans;
Iliac Artery;
Leg;
Neurofibromatoses;
Neurofibromatosis 1;
Neurofibromin 1;
Veins;
Vena Cava, Inferior
- From:Korean Journal of Medicine
2009;77(Suppl 1):S68-S72
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 39-year-old woman, who 3 months prior had undergone sono-guided biopsy for pelvic masses, was admitted to our hospital with dyspnea. After the procedure, a large arteriovenous (AV) fistula was detected. The patient developed dyspnea with pain and swelling of the right leg and subsequently visited our hospital. Multiple cafe-au-lait spots and subcutaneous nodules were noted and a continuous bruit was heard in the right pelvic area. Transthoracic echocardiography revealed marked dilatation of the right atrium, right ventricle, and inferior vena cava. An angiogram showed multiple AV fistulas between the right iliac arteries and veins. The patient underwent aortoiliofemoral bypass surgery. Follow-up echocardiography after surgery showed dramatic improvement in heart function. Molecular analysis revealed a novel variation (c.4270-1G>a) at the 24th intron-exon splicing consensus sequence of the neurofibromin 1 (NF1) gene. This is a rare case of AV fistula that developed after biopsy and caused right-sided heart failure in a patient with neurofibromatosis.
