Percutaneous treatment of high-output right heart failure with pulmonary hypertension due to a large iliac arteriovenous fistula using a patent ductus arteriosus occluder

• Main Authors: Özgür Yaşar Akbal, Aykun Hakgör, Fatih Yılmaz, Seda Tanyeri, Cihangir Kaymaz
• Format: Article
• Language: English
• Published: KARE Publishing 2018-05-01
• Series: Türk Kardiyoloji Derneği Arşivi
• Subjects: arteriovenous fistula; duct occluder; high output heart failure; percutaneous peripheral intervention; pulmonary hypertension.
• Online Access: https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-63847

Presently described is the case of a 41-year-old male patient with signs of high-output right heart failure (HF) due to a possibly iatrogenic arteriovenous fistula (AVF) between the left common iliac artery and the left common iliac vein. Invasively evaluated hemodynamic measurements were consistent with severe shunting, which resulted in precapillary pulmonary hypertension (PH). The AVF was successfully closed with a non-dedicated, 16-mm Amplatzer patent ductus arteriosus occluder (St. Jude Medical, Inc., St. Paul, MN, USA). Although his signs and symptoms were documented to be dramatically improved after closure, because mild PH persisted, adjuvant pulmonary arterial hypertension-targeted treatment with bosentan was initiated to prevent late pulmonary vascular disease.