PEDIATRICS Vol. 57 No. 4 April 1976, pp. 564-568
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Hyperdynamic Heart Failure Due to A-V Fistula Associated With Wilms' Tumor

Shyamal K. Sanyal F.A.A.P., F.A.C.C.1, Victor Saldivar M.D.1, Thomas P. Coburn M.D.1, E. L. Wrenn Jr.1, and Mahesh Kumar M.D.1

1 Pediatric Cardiology, Surgery, and Pathology Services, St. Jude Children's Research Hospital, Memphis, Tennessee

Intrarenal arteriovenous (A-V) fistula associated with Wilms' tumor is extremely rare and is an unusual cause of congestive heart failure in infancy and childhood. In a recent review of 440 children with Wilms' tumor, Miller et al.1 did not find a single case of A-V fistula; nor did Gomes and Bernatz2 find any Wilms' tumors in 139 patients with various forms of A-V fistula. Results of angiographic studies in children with Wilms' tumor are at marked variance as to the occurrence of A-V fistula. Whereas Hidai et al.3 and others4-6 did not find a single patient in whom Wilms' tumor was associated with intrarenal A-V fistula, Cremin et al.7 and Meng and Elkin8 reported such an association in two of 13 and one of 6 children, respectively.