Perioperative Management of a Patient With Decompensated Upper Limb Arteriovenous Malformation Undergoing Shoulder Disarticulation: A Case Report.

Surgical resection of arteriovenous malformations (AVMs) is indicated in the presence of life-threatening and severe morbidity, including symptomatic heart failure, ischemic pain, and recurrent bleeding, where other less invasive treatment strategies have been unable to halt the progression of disease. We present the challenges encountered in the perioperative care of a 23-year-old man with high output cardiac failure, gangrenous hand, and severe chronic pain undergoing shoulder disarticulation for a high-flow complex AVM of the upper limb.