Arteriovenous Aneurysms

Reid, Mont R.; MCGURE, JOHNSON

doi:10.1097/00000658-193810000-00012

Cited by 42 publications

(9 citation statements)

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“…Harrison, Dock and Holman (5) in 1924, using the direct Fick technique, reported that the cardiac output was elevated in their animals with experimental arteriovenous fistulas. Since then, several additional studies in experimental animals have confirmed the earlier observations that the basal cardiac output may be elevated by the creation of an arteriovenous fistula (3,(6)(7)(8). On the other hand, the relatively few clinical observations made on patients with arteriovenous fistulas led to less definitive conclusions; in most instances an increased cardiac output was found (9)(10)(11)(12)(13)(14).…”

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confidence: 76%

The Cardiac Output in Patients With Arteriovenous Fistulas 1

Warren¹,

Nickerson²,

Elkin³

1951

J. Clin. Invest.

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confidence: 76%

The Cardiac Output in Patients With Arteriovenous Fistulas 1

Warren¹,

Nickerson²,

Elkin³

1951

J. Clin. Invest.

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“…While some agreement has been reached on many points, there persists some controversy about most of them (1). It is now generally agreed that an acute as well as a chronic arteriovenous fistula increases the cardiac output (1)(2)(3)(4)(5)(6)(7)(8). However, Lewis and Drury (9) came to the conclusion that the cardiac output is not increased unless the arteriovenous shunt is very large.…”

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confidence: 99%

“…8 Fulbright Fellow, from the Department of Medicine, University of Louvain Medical School, Louvain, Belgium. (3,4,11). However, one group of workers (12) has reported more striking increases of right atrial pressure in dogs with an arteriovenous fistula.…”

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confidence: 99%

“…However, one group of workers (12) has reported more striking increases of right atrial pressure in dogs with an arteriovenous fistula. The blood volume seems to be increased by an arteriovenous fistula of a certain size and duration (3, 13) although some observers (4) suggest that this increase in blood volume occurs only in the presence of an incipient or frank cardiac failure.…”

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confidence: 99%

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An Experimental Study of the Immediate Hemodynamic Adjustments to Acute Arteriovenous Fistulae of Various Sizes 1

Frank¹,

Wang²,

Lammerant³

et al. 1955

J. Clin. Invest.

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In the past thirty years, numerous observations have been made on the hemodynamic effects of arteriovenous fistulae. Arteriovenous fistulae of variable size and location have been studied in patients as well as in animals. Such studies have consisted a) in observing the effect of suddenly opening and closing a fistula in acute experiments, b) in studying the effects of suddenly closing and opening a fistula in an animal or a patient who had had such a fistula for a relatively long time, and c) in recording the effect of complete surgical eradication of a long-standing fistula. While some agreement has been reached on many points, there persists some controversy about most of them (1). It is now generally agreed that an acute as well as a chronic arteriovenous fistula increases the cardiac output (1-8). However, Lewis and Drury (9) came to the conclusion that the cardiac output is not increased unless the arteriovenous shunt is very large. Van Loo and Heringman (10) concluded that acute arteriovenous fistulae increase the cardiac output although the flow of blood in certain vascular areas outside the fistula circuit is decreased. The venous pressure is definitely increased near the site of the arteriovenous communication, but most investigators have found that the increment of venous pressure decreases rapidly as the pressure is measured further down the venous bed toward the right atrium, and in the venae cavae and right atrium the pressure is elevated little or not at all I This work was made possible by a grant-in-aid from the New York Heart Association, the Sidney A. Legendre Gift, and the Charles A. Frueauff Gift. It was presented at the Annual Meeting of the American Physiological Society in New York City in 1952.2Fellow of the New York Heart Association. (3, 4, 11). However, one group of workers (12) has reported more striking increases of right atrial pressure in dogs with an arteriovenous fistula. The blood volume seems to be increased by an arteriovenous fistula of a certain size and duration (3, 13) although some observers (4) suggest that this increase in blood volume occurs only in the presence of an incipient or frank cardiac failure.Since the magnitude of the effects of an arteriovenous fistula would seem a priori to depend upon the volume of blood shunted through the abnormal pathway, it is rather surprising that in no study has any attempt been made to measure simultaneously the rate of flow through the fistula and the other functions of interest such as cardiac output, arterial and venous pressures. The present study was undertaken in an attempt to determine the acute cardiovascular adjustments to arteriovenous fistulae of different sizes, by recording simultaneously and continuously the flow of blood through the fistula, the flow of blood into the systemic circulation exclusive of the arteriovenous fistula circuit, the mean arterial blood pressure and the mean central venous pressure. METHODSFifteen dogs weighing between 13 and 28 kilograms were anesthetized by the intravenous infusion of 100 m...

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“…In 1924, Holman reported that the volume of distribution of protein-bound dyes was increased in the presence of an arteriovenous fistula (11). Although these findings were confirmed in certain subsequent studies (12-16), they were not supported by others (17,18). Warren, Elkin, and Nickerson reported that less than half of forty-one patients with an arteriovenous fistula had a significant fall in blood volume estimated from the T-1824 space following surgical repair of the defect (19).…”

Section: Discussionmentioning

confidence: 94%

The Effect of the Formation of an Arteriovenous Fistula Upon Blood Volume 1

Epstein¹,

Ferguson²

1955

J. Clin. Invest.

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The creation of a large peripheral arteriovenous fistula results in a series of related physiologic adjustments, including changes in cardiac output, intravascular and intracardiac pressures, blood flow to peripheral organs and urinary excretion of water and electrolytes (1-3). The changes in blood volume which occur under these circumstances have been the subject of controversy, partly because observations made before and after surgical extirpation of a fistula are necessarily complicated by the effects of a major operation and the patient's convalescence.Previous efforts to resolve this question have utilized protein-binding dyes such as T-1824 or Brilliant Vital Red to measure blood volume. However, the accuracy of T-1824 as a measure of total blood volume is open to question (4) and its validity as an index to the intravascular volume of plasma in certain conditions has been challenged (5, 6). For these reasons it was decided to reinvestigate the early effect of an experimental arteriovenous fistula upon blood volume, and to use labelled red cells as well as T-1824 in an attempt to measure by independent methods changes in the volume of red cells and plasma. METHODSSeven trained mongrel dogs, weighing 10 to 18 kilograms, were fed a standard meal diet to which raw meat and ferrous sulfate were added. After control measurements of blood volume in the unanesthetized, fasting state, an arteriovenous fistula approximately one cm. long was created surgically between the abdominal aorta and the inferior vena cava, halfway between the renal vessels and the bifurcation. From two to six weeks after the operation, the blood volume was remeasured.Five cc. of the dog's own blood were incubated at room temperature for 30 minutes with P'. After labelling, the red cells were washed three times with cold 1

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Arteriovenous Aneurysms

Cited by 42 publications

References 0 publications

The Cardiac Output in Patients With Arteriovenous Fistulas 1

The Cardiac Output in Patients With Arteriovenous Fistulas 1

An Experimental Study of the Immediate Hemodynamic Adjustments to Acute Arteriovenous Fistulae of Various Sizes 1

The Effect of the Formation of an Arteriovenous Fistula Upon Blood Volume 1

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