Congenital Arteriovenous Fistula of Left Extremity A Case Report

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M. T., female, aged 19Hypertrophy of the left lower extremity was noticed at age 12, since then it was gradually increased with fatigue. Her right leg showed obvious muscular atrophy and drop foot (resulted from polimyelitis at age 3). No other symptoms.On the examination of heart, functional murmurs was listened. C. T. R. was 51.2% and blood pressure 136-148/80mmHg preoperatively. No pulmonary congestion. On regional findings, whole left leg showed obvious hypertrophy with increase of skin temperature and normal skin color, but with the dilatation of superficial veins.Over the popliteal space, left inguinal region, and the anterior upper side of the left calf were felt the characteristic thrills and bruits of arteriovenous fistulae.O2-saturation and pH of the left femoral and dorsal veins showed respective 97%, pH 7.410 and 79%, pH 7.372.X-ray showed discrepancy of 6.7cm in length of whole extremity. Angiogram demonstrated dilation of A. and V. femoralis and defect of dye in the peripheral artery suggested arteriovenous shunts at the level of the popliteal space.Under epidural anesthesia, an incision was made over the popliteal space. The greatly dilated popliteal vein was exposed, in which was observed "whirlpool phenomenon". Longitudinal suture of the defect in the wall of the vessel was performed and distal popliteal vein was ligated.
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