Doppler Ultrasonography-Guided Surgery for High-Flow Hemodialysis Vascular Access: Preliminary Results

Tellioglu, Gurkan; Berber, İbrahim; Kilicoglu, Gamze; Seymen, Pınar; Kara, Muammer; Titiz, İzzet

doi:10.1016/j.transproceed.2007.11.059

Cited by 23 publications

(19 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although previous reports have demonstrated that high fistula flow is correlated with high cardiac output [3,5], AVFs are rarely complicated with high-output heart failure in patients under hemodialysis [1][2][3][4][5]. Closure or flow reduction of AVF can improve AVFassociated high-output heart failure [1][2][3][4], however, the effect of these procedures on hemodynamics has not been precisely assessed by right-heart catheterization in previous reports.…”

Section: Discussionmentioning

confidence: 99%

“…High-output heart failure is a rare complication of arteriovenous fistulas (AVF) for hemodialysis [1][2][3][4][5]. Although closure or flow reduction of AVF has been known to improve highoutput status [1][2][3][4], few data exist regarding the impact of these procedures on systemic hemodynamics.…”

Section: Introductionmentioning

confidence: 99%

“…Although closure or flow reduction of AVF has been known to improve highoutput status [1][2][3][4], few data exist regarding the impact of these procedures on systemic hemodynamics. We report here a case of high-output heart failure due to a high-flow AVF who was successfully treated by the inflow reduction procedure.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of inflow reduction of arteriovenous fistula on systemic hemodynamics in a patient with high-output heart failure during hemodialysis: A case report

Araki

Katano

et al. 2010

Journal of Cardiology Cases

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of inflow reduction of arteriovenous fistula on systemic hemodynamics in a patient with high-output heart failure during hemodialysis: A case report

Araki

Katano

et al. 2010

Journal of Cardiology Cases

View full text Add to dashboard Cite

show abstract

“…To date, there is no consensus as to the threshold flow values in the management of steal syndrome, PH and cardiac failure in patients under chronic HD [48, 49]. The causal link between access flow and increased morbi-mortality probably exists, but still needs to be directly proven [8, 50].…”

Section: Haemodynamic Impacts Of High-flow Avf In Patients Under Chromentioning

confidence: 99%

Controversies in the management of the haemodialysis-related arteriovenous fistula following kidney transplantation

Vanderweckene

Weekers

Lancellotti

et al. 2017

Clinical Kidney Journal

View full text Add to dashboard Cite

Arteriovenous fistula (AVF) is regarded as the best vascular access for chronic haemodialysis (HD). Still, AVF inherently causes significant haemodynamic changes. Although the necessity for vascular access despite its putative cardiovascular complications favours AVF creation in patients under chronic HD, one may question whether sustaining a functional AVF after successful kidney transplantation extends the haemodynamic threat. Small prospective series suggest that AVF ligation causes rapid and sustained reduction in left ventricular hypertrophy. Still, the benefits of such a cardiac remodelling in long-terms of cardiovascular morbi-mortality still need to be proven. Furthermore, the elevation of diastolic blood pressure and arterial stiffness caused by AVF ligation may blunt the expected cardio-protection. Finally, the closure of a functioning AVF may accelerate the decline of kidney graft function. As a whole, the current management of a functioning AVF in kidney transplant recipients remains controversial and does not rely on strong evidence-based data. The individual risk of graft dysfunction and a return to chronic HD also needs to be balanced. Careful pre-operative functional assessments, including cardio-pulmonary testing and estimated glomerular filtration rate slope estimation, may help better selection of who might benefit the most from AVF closure. Large-scale prospective, ideally multi-centric, trials are essentially needed.

show abstract

“…Several surgical techniques have been proposed for the treatment of high‐output heart failure: all are based on the attempt to increase resistance at the level of the anastomosis or of the venous outflow (reduction of the caliber of the AVF anastomosis, interposition of a prosthetic graft, banding), with the hope of obtaining a reduction of Qa (16). In such cases an assessment of Qa by means of intra‐operative Doppler ultrasound is mandatory (17). This will avoid failures or excessive reductions in the caliber of the anastomosis, since too a drastic reduction of Qa exposes the AVF to a thrombogenic risk.…”

Section: How Should An Arterio‐venous Access Be Modified Because Of Amentioning

confidence: 99%

When and how should an arterio‐venous access be modified because of a high blood flow rate?

Basile

Lomonte

2011

Seminars in Dialysis

View full text Add to dashboard Cite

Doppler Ultrasonography-Guided Surgery for High-Flow Hemodialysis Vascular Access: Preliminary Results

Cited by 23 publications

References 8 publications

Impact of inflow reduction of arteriovenous fistula on systemic hemodynamics in a patient with high-output heart failure during hemodialysis: A case report

Impact of inflow reduction of arteriovenous fistula on systemic hemodynamics in a patient with high-output heart failure during hemodialysis: A case report

Controversies in the management of the haemodialysis-related arteriovenous fistula following kidney transplantation

When and how should an arterio‐venous access be modified because of a high blood flow rate?

Contact Info

Product

Resources

About