Authors: Dabbagh, Ali¹; ashi, Ali S. Mar'²; Malek, Bahman¹

Source: Military Medicine, Volume 172, Number 10, October 2007 , pp. 1129-1131(3)

Publisher: AMSUS - Association of Military Surgeons of the U.S.

Abstract:

A 75-year-old man referred to the outpatient vascular surgery clinic of Taleghani Hospital (Shaheed Beheshti University of Medicine, Tehran, Iran) due to a local nontender mass in his groin. In his history, it was discovered that the mass had appeared a few months after a gunshot injury. He had a history of shortness of breath with a New York Heart Association functional class fluctuating between II and III, but no history of smoking or addiction. In the physical examination, a 5-cm by 5-cm nonpulsatile mass with engorged vessels was found in the anterior portion of the left groin, which was not tender. An elective arterial angiography revealed an arteriovenous fistula joining the femoral artery to the femoral vein at the left groin. The cardiac assessments revealed cor pulmonale (with a restrictive pattern and diastolic dysfunction) and pulmonary hypertension due to primary pulmonary dysfunction. The patient was anesthetized with a balanced general anesthesia method, considering all relevant cardiac and respiratory monitoring methods and specially withholding drugs increasing pulmonary vascular bed pressure, suppressing the myocardium, or increasing the regurgitant flow across the mitral and, especially, the tricuspid valve. The moment the fistula was closed, a rapid fall in the patient's heart rate was noted, from approximately 60 beats per minute to above 40 beats per minute; this decreased heart rate continued up to a few hours after the surgery and did not accompany any significant hemodynamic derangement including the patient's blood pressure. The patient received his postoperative care in the ordinary surgical ward and was discharged a few days later.

Document Type: Research article

Affiliations: 1: Assistant Professor, Anesthesiology, Taleghani Hospital, Shaheed Beheshti University, Velenjak, Tehran, 1985717413, Iran. 2: Assistant Professor, Vascular Surgery, Department of Surgery, Taleghani Hospital, Shaheed Beheshti University, Velenjak, Tehran, 1985717413, Iran.

Publication date: 2007-10-01

More about this publication?

• Military Medicine is the Association's official monthly journal. The objective of the Journal is to promote awareness of Federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to Federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members' writings.
• Editorial Board
• Information for Authors
• Submit a Paper
• Subscribe to this Title
• Membership Information
• Information for Advertisers
• Terms & Conditions
• Reviewer Information
• ingentaconnect is not responsible for the content or availability of external websites

Related content

• In this: publication
• By this: publisher
• In this Subject: Medicine (General) ,  Political Science
• By this author: Dabbagh, Ali ;  ashi, Ali S. Mar' ;  Malek, Bahman

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers