The Netherlands journal of surgery
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The only effective treatment of an aortocaval fistula is the surgical closure of the fistula opening with insertion of an aortic prosthesis to restore the arterial continuity. The diagnosis of this distinct but infrequent clinical entity is often missed because of lack of suspicion. Proper preoperative evaluation facilitates the choice of surgical approach and reduces the morbidity. ⋯ Cardiac failure was present in two of them. Successful surgical closure could be accomplished in two patients although the perioperative course was complicated by ventricular arrhythmia, profuse blood loss and an inferior vena cava syndrome. One patient with a spontaneous aortocaval fistula passed away due to intraoperative exsanguination.