Congestive heart failure due to an iatrogenic arteriovenous fistula in a patient with neurofibromatosis-1 |
E Ryoung Choi, Su Jin Lee, Soo Min Kim, Hee Jung Choi, Chang-Seok Ki, Yeon Hyeon Choi, Duk-Kyung Kim |
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신경섬유종증 제1형 환자에서 의인성 동정맥루로 인한 심부전 1예 |
최이령, 이수진, 김수민, 최희정, 기창석, 최연현, 김덕경 |
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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. |
Key Words:
Arteriovenous fistula; Congestive heart failure; Neurofibromatosis type 1 |
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