Successful open surgical repair of large ilio-caval fistula presenting with congestive heart failure

Ilio-caval arteriovenous fistula is a rare sequel of lumbar disc surgery or penetrating injury. We report a case of 40-year gentleman presenting with symptoms of congestive heart failure and continuous murmur heard over right iliac fossa. His past history was significant for lumbar disc surgery done twice 1 year back. Computed tomography angiogram confirmed a large fistulous communication between right common iliac artery and inferior vena cava. Open surgical repair was performed as the fistula was not well suited for endovascular repair. We successfully managed this case by open surgical ligation of right common iliac artery proximal and distal to fistula and continuity restored with interposition Dacron graft. He was relieved of symptoms and performing well on follow-up.