Korean J Thorac Cardiovasc Surg.  2005 Oct;38(10):721-724.

Aortocaval Fistula: A case report

• Yoon YC
• Cho KH
• Kwon YM
• Han IY
• Jun HJ
• Lee YH
• Hwang YH

Abstract

Aortocaval fistula is a rare complication of abdominal aortic aneurysm, involving less than 1% of all abdominal aortic aneurysms. A 64-years old man with a long history of hypertension and abdominal aortic aneurysm had chest pain, dyspnea, epigastric discomfort and palpable abdominal pulsating mass. Physical examination revealed hypotension with a systolic blood pressure of 70 mmHg, a large pulsatile mass and a systolic abdominal bruit. Laboratory data revealed a hemoglobin values of 11.0 g/dL, blood urea nitrogen (BUN) value of 5 mg/dL, and creatine value of 2.6 mg%. Abdominal Angio CT showed a 10 cm infrarenal abdominal aortic aneurysm with dilatation of the IVC and aortocaval fistula from the aortic aneurysm, which was confirmed at emergency surgery. When the aneurysm was opened and the thrombus was removed, a 1 cm communication was identified between the aorta and IVC. This was controlled with Foley catheters ballooning, and the fistula was closed by continuous suture placed outside the aneurysm. A bifurcated aorto-iliac graft was used to restore arterial continuity. The patient was discharged home after uncomplicated postoperative course.

Keyword

Aortic dissection; Aortic aneurysm, abdominal; Aortic fistula; Vena cava, inferior

MeSH Terms

Aneurysm
Aorta
Aortic Aneurysm
Aortic Aneurysm, Abdominal
Blood Pressure
Blood Urea Nitrogen
Catheters
Chest Pain
Creatine
Dilatation
Dyspnea
Emergencies
Fistula*
Humans
Hypertension
Hypotension
Middle Aged
Physical Examination
Sutures
Thrombosis
Transplants
Vena Cava, Inferior
Creatine