A Rare Case of Traumatic Innominate-Innominate Arteriovenous Fistula

Dambuza Nyamande, Pule Mutati, Siphosenkosi Mazibuko, Risenga F. Chauke

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Background: Case Report: Conclusions: Rare disease This report presents a rare case of a traumatic innominate artery to left innominate vein fistula following a stab wound to the base of the neck. We report a case of a 23-year-old patient with a traumatic innominate-innominate arteriovenous fistula, after being stabbed in the suprasternal notch area 3 years prior. The patient presented with fatigue, and shortness of breath on exertion. Examination revealed a wide pulse pressure, bounding pulses, and a continuous murmur on the upper sternal area. Chest X-rays, echocardiography, CT angiography, and cardiac catheterization were useful to aid in diagnosis and work-up for fistula repair. A complex 8-mm fistula between the left innominate vein and the proximal innominate artery was noted, with multiple tortuous channels and demonstrating a reversible left-to-right shunt. After medical optimization, successful surgical ligation and division of the fistula was done through median sternotomy without cardiopulmonary bypass. The postoperative recovery was uneventful. Traumatic innominate-innominate arteriovenous fistulas are rare and can pose a diagnostic challenge. High index of suspicion, careful history, examination, and radiologic evaluation usually result in correct diagnosis. Endovascular and surgical approaches are the mainstay treatment.

Original languageEnglish
Article numbere934270
JournalAmerican Journal of Case Reports
Volume23
Issue number1
DOIs
Publication statusPublished - 2022

Keywords

  • Advanced Trauma Life Support Care
  • Aorta, Thoracic
  • Arteriovenous Fistula

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