Right-Sided Heart Failure due to Lumbar Disc Surgery: A Case Report

Right-sided heart failure may occur during or after cardiac and noncardiac surgeries. One reason for right-sided heart failure in noncardiac surgeries is pulmonary hypertension (PH). In this report, we describe a 51-year-old man suffering from complications of right-sided heart failure, with an unknown cause. The patient had dyspnea (WHO functional class III), abdominal pain, anorexia, weight loss, bilateral lower limb swelling, icteric sclera, and elevated jugular venous pressure. Echocardiography showed mild enlargement and systolic dysfunction of the left ventricle, moderate enlargement and dysfunction of the right ventricle, and a systolic pulmonary arterial pressure of 60 mm Hg. After several workups, it was diagnosed that his previous lumbar disc surgery had resulted in an arteriovenous fistula and the consequent PH, leading to right-sided heart failure. After the occlusion of the arteriovenous fistula, all signs and symptoms were resolved. Accordingly, iatrogenic arteriovenous fistulae should be considered a reversible cause of right-sided heart failure.