Management of a complex, posttraumatic, pelvic arteriovenous fistula with the use of cardiopulmonary bypass: Case report and review of the literature

Richard J. Fowl, Richard F. Kempczinski, Warren W. Bailey, William H. Dickhoner

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

A 34-year-old man had a posttraumatic, pelvic arteriovenous fistula (AVF) and false aneurysm of 18 years' duration. He had undergone four previous unsuccessful attempts at operative repair, the last of which almost resulted in exsanguination. After the false aneurysm was exposed, the patient was placed on cardiopulmonary bypass. Core cooling (25° C) allowed the perfusion flow rates to be lowered (less than 0.5 L/min/m2) while the aneurysm was opened, thereby permitting visualization and ligation of the arteriovenous communications within the aneurysm. Total circulatory arrest was not required. There were no complications and the patient was discharged on the eleventh postoperative day. Arteriography 5 months later showed complete ablation of the AVF. We believe that cardiopulmonary bypass with hypothermia and reduced blood flow is a useful adjunct in the repair of complex AVFs and arteriovenous malformations. This technique avoids the use of total circulatory arrest, which increases the risks of air embolism and ischemic organ injury.

Original languageEnglish (US)
Pages (from-to)257-261
Number of pages5
JournalJournal of vascular surgery
Volume6
Issue number3
DOIs
StatePublished - Sep 1987

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ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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