Congenital subclavian-superior vena cava arteriovenous fistula with initial stenosis in an adult: a case report

BMC Cardiovasc Disord. 2020 Aug 17;20(1):376. doi: 10.1186/s12872-020-01660-5.

Abstract

Background: A subclavian-superior vena cava arteriovenous fistula is usually acquired and secondary to trauma or operations, while congenital causes are very rare. A congenital arteriovenous fistula leads to congestive heart failure soon after birth and is typically diagnosed in early infancy.

Case presentation: We present an unusual case of a 21-year-old female suffering from new-onset heart failure at 20 years old who was diagnosed with a congenital arteriovenous fistula from the right subclavian artery to the superior vena cava (RSA-to-SVC) with stenosis at the proximal initial site of the fistula. The patient successfully underwent transcatheter occlusion for the fistula and had a significant improvement in symptoms at the 3-month follow-up.

Conclusions: An RSA-to-SVC fistula is a very rare congenital disorder that can lead to shunt-related heart failure. If there is an indication for closure, as with the patient presented, percutaneous device closure can be considered a reasonable option.

Keywords: Adult; Case report; Congenital arteriovenous fistula; Fistula stenosis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Video-Audio Media

MeSH terms

  • Arteriovenous Fistula / complications*
  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / physiopathology
  • Arteriovenous Fistula / therapy
  • Cardiac Catheterization / instrumentation
  • Constriction, Pathologic
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / etiology*
  • Heart Failure / physiopathology
  • Humans
  • Recovery of Function
  • Septal Occluder Device
  • Subclavian Artery / abnormalities*
  • Subclavian Artery / diagnostic imaging
  • Subclavian Artery / physiopathology
  • Treatment Outcome
  • Vena Cava, Superior / abnormalities*
  • Vena Cava, Superior / diagnostic imaging
  • Vena Cava, Superior / physiopathology
  • Young Adult