Anesthetic Management of High-Output Heart Failure in Aortocaval Fistula Using Intra-aortic Balloon Occlusion: A Case Report

An aortocaval fistula caused by rupture of a right common iliac arterial aneurysm is a rare but potentially fatal condition that can progress to acute heart failure and even multi-organ failure due to abnormal shunting of blood through the fistula. We report a case of a patient with such a fistula who was rapidly diagnosed, and following emergent surgical consultation, underwent intra-aortic balloon occlusion prior to laparotomy. This intervention promptly stabilized the patient's circulation by addressing the high-output heart failure.