Hyperdynamic Heart Failure Due to A-V Fistula Associated With Wilms' Tumor

Intrarenal arteriovenous (A-V) fistula associated with Wilms9 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 Wilms9 tumor, Miller et al.1 did not find a single case of A-V fistula; nor did Gomes and Bernatz2 find any Wilms9 tumors in 139 patients with various forms of A-V fistula. Results of angiographic studies in children with Wilms9 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 Wilms9 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.