A rare complication of laparoscopic surgery: Iatrogenic arteriovenous fistula with high-output cardiac failure

The authors report a 19-year-old man with cardiomegaly and high-output cardiac failure resulting from a hemodynamically significant arteriovenous fistula that was diagnosed 18 months after laparoscopic surgery for an inguinal hernia. The diagnosis was established on clinical examination and by ultrasonography and was confirmed by cardiac catheterization and angiography. The fistula was closed surgically by direct venous suture and reconstruction of the iliac artery with a polytetrafluoroethylene patch. The surgical repair achieved complete closure of the fistula with rapid normalization of cardiac size and function within 8 days.