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Heart Failure and Severe Pulmonary Hypertension Secondary to a Giant Renal Arteriovenous Malformation

Renal arteriovenous malformations (AVMs) are anomalous communications between the arterial and venous systems of the kidneys, with no intermediate capillary vessels. 1,2 The malformations may be either congenital or acquired, the latter being much more common. In 75% of cases, the initial sign of a renal AVM is gross hematuria, 1-3 and large malformations may cause heart failure. 1,2,4 We report a case of severe pulmonary hypertension and heart failure with no hematuria secondary to a giant congenital renal AVM in a 61-year-old woman. The disorder was diagnosed first with duplex color Doppler sonography and later confirmed by computed tomography (CT), magnetic resonance angiography, and angiography A laparoscopic nephrectomy was performed successfully.