Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

07 July 2019 : Case report  Poland

Iatrogenic Arteriovenous Fistula and Atrial Septal Defect Following Cryoballoon Ablation for Atrial Fibrillation – Two Correctable Causes of Right Heart Failure

Diagnostic / therapeutic accidents

Katarzyna Dudzińska-Szczerba1ABDEF*, Roman Piotrowski1AB, Beata Zaborska1B, Ewa Pilichowska-Paszkiet1B, Małgorzata Sikora-Frąc1B, Anna Żuk1B, Paweł Lewandowski1B, Piotr Kułakowski1E, Jakub Baran1ABCDE

DOI: 10.12659/AJCR.916205

Am J Case Rep 2019; 20:971-974

Abstract

BACKGROUND: Catheter ablation for atrial fibrillation is an important therapeutic intervention. One of the most frequent complications of this procedure is vascular issues including arteriovenous fistula. Iatrogenic atrial septal defect (IASD) has been reported as a complication of transseptal puncture; however, no data are available demonstrating any coexistent of arteriovenous fistula with IASD.

CASE REPORT: A 61-year-old female patient was admitted to our center for catheter ablation for persistent atrial fibrillation. Her past medical history was significant for cryoballoon ablation for atrial fibrillation in 2015, which was subsequently complicated by hematoma and arteriovenous fistula at puncture site. After general surgery consultation, the patient was qualified for conservative treatment. To exclude left atrial thrombus before redo procedure, transesophageal echocardiography was performed which visualized the presence of 9-mm atrial septal defect with left-to-right shunting, detecting right-to-left shunting using Valsalva maneuver. No significant valvular abnormalities were identified. The next day, pulmonary vein isolation for atrial fibrillation was performed. One month later, a control transthoracic echocardiogram (TTE) revealed hemodynamic significant left-to-right shunting with Qp/Qs 2.0 and high probability of pulmonary hypertension. Vascular surgery for arteriovenous fistula was successfully performed in October 2018. Subsequent TTE, performed a month later, confirmed no left-to-right shunting and no signs of pulmonary hypertension or diminishment of the right atrium.

CONCLUSIONS: Vascular access during catheter ablation for atrial fibrillation may result in arteriovenous fistula. This condition might affect right atrium pressure leading to increased diameter of previous puncture site at the interatrial septum, causing IASD with significant shunting. In this group of patients, arteriovenous fistula should be treated as soon as possible.

Keywords: Arteriovenous Fistula, Atrial Fibrillation, Catheter Ablation, Heart Septal Defects, Atrial, Cryosurgery, Echocardiography, Transesophageal, Iatrogenic Disease, Postoperative Complications, Vascular Surgical Procedures

Add Comment 0 Comments

In Press

Case report  Italy

Optimizing Surgical Techniques for Anal Canal Duplications in 2 Pediatric Patients

Am J Case Rep In Press; DOI: 10.12659/AJCR.945747  

Case report  China

A 73-Year-Old Man Presenting with Shoulder Muscle Pain and a Diagnosis of Guillain-Barré Syndrome

Am J Case Rep In Press; DOI: 10.12659/AJCR.945539  

Case report  China

Diagnostic Challenges in Sporadic Creutzfeldt-Jakob Disease: A Case Study of Typical Clinical Presentation ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.945795  

Case report  China

Minimally Invasive Management of Infantile Dacryocystitis with Lacrimal Abscess: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.946588  

Most Viewed Current Articles

21 Jun 2024 : Case report  China (mainland) 88,518

Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...

DOI :10.12659/AJCR.944371

Am J Case Rep 2024; 25:e944371

0:00

07 Mar 2024 : Case report  USA 50,005

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

20 Nov 2023 : Case report  Saudi Arabia 25,154

Azithromycin Treatment for Acne Vulgaris: A Case Report on the Risk of Clostridioides difficile Infection

DOI :10.12659/AJCR.941424

Am J Case Rep 2023; 24:e941424

0:00

18 Feb 2024 : Case report  Japan 22,640

A Case of Thoracic Empyema Caused by Actinomyces naeslundii

DOI :10.12659/AJCR.943030

Am J Case Rep 2024; 25:e943030

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923