Impact of Inflow Reduction of Arteriovenous Fistula on Systemic Hemodynamics in a Patient with High-output Heart Failure During Hemodialysis: A Case Report

Overview

Journal J Cardiol Cases

Specialty Cardiology & Vascular Diseases

Date 2019 Jan 8

PMID 30615738

Citations 1

Authors

Kotaro Oe

Tsutomu Araki

Kenichi Katano

Yasushi Kakuchi

Akikatsu Nakashima

Tetsuo Konno

Noboru Fujino

Hidekazu Ino

Masakazu Yamagishi

Affiliations

Soon will be listed here.

Abstract

A 68-year-old woman was admitted with dyspnea. The patient had been treated with hemodialysis for renal failure for 11 years. On admission, chest X-ray showed pulmonary edema. Right-heart catheterization revealed high cardiac output (11.8 l/min) and elevated pulmonary capillary wedge pressure (PCWP). Doppler ultrasonography showed high-flow of an arteriovenous fistula (AVF) for hemodialysis. The patient was diagnosed as having high-output heart failure due to a high-flow AVF. Inflow reduction of the AVF was performed by proximal radial artery ligation. Right-heart catheterization performed 2 weeks after the operation revealed that cardiac output had decreased from 11.8 to 9.5 l/min and PCWP was also reduced from 21 to 9 mmHg. Furthermore, flow of the AVF measured by Doppler ultrasonography was also decreased. To our knowledge, this is the first report that assessed hemodynamics of high-output heart failure before and after inflow reduction of the AVF by repeated right-heart catheterization.

Citing Articles

Cardiac complications of arteriovenous access: a narrative review from a multidisciplinary team perspective.

Stathopoulou M, Tsimpoukis A, Tasios K, Papageorgopoulou C, Mulita F, Leivaditis V Arch Med Sci Atheroscler Dis. 2025; 9:e217-e225.

PMID: 40007983 PMC: 11851310. DOI: 10.5114/amsad/196826.

Effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients.

Saleh M, El Kilany W, Keddis V, Said T Egypt Heart J. 2018; 70(4):337-341.

PMID: 30591752 PMC: 6303531. DOI: 10.1016/j.ehj.2018.10.007.

References

Pandeya S, Lindsay R . The relationship between cardiac output and access flow during hemodialysis. ASAIO J. 1999; 45(3):135-8. DOI: 10.1097/00002480-199905000-00006. View

MacRae J, Pandeya S, Humen D, Krivitski N, Lindsay R . Arteriovenous fistula-associated high-output cardiac failure: a review of mechanisms. Am J Kidney Dis. 2004; 43(5):e17-22. DOI: 10.1053/j.ajkd.2004.01.016. View

Chemla E, Morsy M, Anderson L, Whitemore A . Inflow reduction by distalization of anastomosis treats efficiently high-inflow high-cardiac output vascular access for hemodialysis. Semin Dial. 2007; 20(1):68-72. DOI: 10.1111/j.1525-139X.2007.00244.x. View

Basile C, Lomonte C, Vernaglione L, Casucci F, Antonelli M, Losurdo N . The relationship between the flow of arteriovenous fistula and cardiac output in haemodialysis patients. Nephrol Dial Transplant. 2007; 23(1):282-7. DOI: 10.1093/ndt/gfm549. View

Tellioglu G, Berber I, Kilicoglu G, Seymen P, Kara M, Titiz I . Doppler ultrasonography-guided surgery for high-flow hemodialysis vascular access: preliminary results. Transplant Proc. 2008; 40(1):87-9. DOI: 10.1016/j.transproceed.2007.11.059. View