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High-Output Heart Failure Due to a Renal Arteriovenous Fistula in a Pregnant Woman With Suspected Preeclampsia  Tommy S. Korn, M.D., Jeffrey M. Thurston,

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Presentation on theme: "High-Output Heart Failure Due to a Renal Arteriovenous Fistula in a Pregnant Woman With Suspected Preeclampsia  Tommy S. Korn, M.D., Jeffrey M. Thurston,"— Presentation transcript:

1 High-Output Heart Failure Due to a Renal Arteriovenous Fistula in a Pregnant Woman With Suspected Preeclampsia  Tommy S. Korn, M.D., Jeffrey M. Thurston, M.D., Cynthia S. Sherry, M.D., Darryl L. Kawalsky, M.D.  Mayo Clinic Proceedings  Volume 73, Issue 9, Pages (September 1998) DOI: / Copyright © 1998 Mayo Foundation for Medical Education and Research Terms and Conditions

2 Fig. 1 Contrast-enhanced computed tomogram at renal hilar level, showing asymmetry of nephrograms, relatively delayed on right, and marked enhancement of tortuous large-caliber vessels filling renal pelvis and approaching distended inferior vena cava. AVF = arteriovenous fistula. Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 1998 Mayo Foundation for Medical Education and Research Terms and Conditions

3 Fig. 2 Subtraction image from aortogram, showing pooling of contrast medium in giant vascular channels, resulting in early filling of distended inferior vena cava (IVC), compatible with arteriovenous shunting. Enlarged tributaries extend radially. Pressure within IVC equaled that within aorta. Selective catheterization of renal vein resulted in repeated deflection of catheter back into IVC because of marked turbulence of flow. IVC was dilated with a diameter 3 times larger than diameter of aorta. AC = aortic catheter; AVF = arteriovenous fistula. Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 1998 Mayo Foundation for Medical Education and Research Terms and Conditions

4 Fig. 3 Gross specimen of 250-g distorted kidney, 10 by 9 by 5.5 cm, with small amount of attached perirenal fat. Specimen is bivalved to reveal aneurysm, 5 by 5 by 4.5 cm, that appeared to communicate with renal artery. (Photograph courtesy of Dr. Beverly A. Dickson.) Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 1998 Mayo Foundation for Medical Education and Research Terms and Conditions


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