Iatrogenic arteriovenous fistula in the groin presenting as cardiac failure

A patient presented with cardiac failure and investigations revealed a right femoral arteriovenous fistula (AVF) 5 weeks after the insertion of a femoral dialysis catheter for haemodialysis. No ultrasound had been used for catheter insertion. The iatrogenic AVF was repaired, and her episodes of cardiac failure ceased. It is recommended that femoral dialysis catheters are inserted using ultrasound guidance to avoid inadvertent arterial puncture.