High output cardiac failure due to iatrogenic A–V fistula in scar: a report of a case and review of the literature

Pagel, Albert; Bass, Arie; Strauß, Simon; Peleg, Eli; Mj, Rapoport

doi:10.1016/s0967-2109(03)00058-9

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…Diagnosis can be confirmed with color Doppler ultrasonography, digital subtraction angiography, or magnetic resonance angiography. The gold standard is to demonstrate on contrast angiography direct imaging of the abnormal arteriovenous communication and definition of the adjacent vessels [ 5 , 16 ]. However systemic and neurologic complications related to contrast angiography occur in patients.…”

Section: Discussionmentioning

confidence: 99%

High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old

Teomete

Gugol

Neville

et al. 2016

Case Reports in Vascular Medicine

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Background. Acquired AVF in pediatrics are commonly caused by iatrogenic means, including arterial or venous punctures. These fistulae can cause great hemodynamic stress on the heart as soon as they are created. Case. A six-month-old 25-week gestation infant was referred for respiratory distress. Initial exam revealed tachypnea, tachycardia, and hypertension. There was a bruit noted on her left arm. An ultrasound showed an arteriovenous fistula. Its location, however, precluded intervention because of the high risk for limb-loss. An echocardiogram showed evidence of pulmonary hypertension that was treated with sildenafil and furosemide. However, no improvement was seen. On temporary manual occlusion of the fistula, the patient was noted to have increased her blood pressure and decreased her heart rate, suggesting significant hemodynamic effect of the fistula. The fistula was subsequently ligated and the patient clinically and echocardiographically improved. Conclusion. A patient in high output cardiac failure or pulmonary artery hypertension, especially prematüre patients with preexisting lung disease, should be probed for history of multiple punctures, trauma, or surgery and should have prompt evaluation for AVF. If it can be diagnosed and repaired, most of the cases have been shown to decrease the stress on the heart and reverse the pathologic hemodynamics.

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Section: Discussionmentioning

confidence: 99%

High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old

Teomete

Gugol

Neville

et al. 2016

Case Reports in Vascular Medicine

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“…Ongoing vascular and clinical assessments are important to determine if a fistula is likely to be viable for routine haemodialysis (Ram et al 2001, Vanholder 2001. There are, however, several clinical problems which can arise, including inability to use the fistula because of narrowing or occlusion, vascular steal from the hands which can result from excessively high flow, and high output cardiac failure (Gani et al 1991, Besarab et al 1997, Ram et al 2001, Goff et al 2000, Pagel et al 2003.…”

Section: Introductionmentioning

confidence: 99%

Thermography and colour duplex ultrasound assessments of arterio-venous fistula function in renal patients

Allen¹,

Oates²,

Chishti³

et al. 2005

Physiol. Meas.

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Vascular and clinical assessments of arterio-venous fistula (AVF) function and access are important in patients undergoing or preparing to undergo renal dialysis. Objective assessment techniques include colour duplex ultrasound and more recently medical infrared thermography. Ideally, these should help assess problems relating to fistula failure or to vascular steal from the hand which can result from excessive fistula blood flow. The clinical value of thermography, as yet, has not been assessed for this patient group. The aims of this study were therefore to investigate the relationships between thermography skin temperature measurement and (a) quantitative ultrasound measurement of AVF blood flow, and (b) qualitative clinical assessment of vascular steal from the hands. Fifteen adult patients underwent thermal imaging of the upper limbs, colour duplex ultrasound to derive AVF blood flow from brachial artery blood flow measurements, and a clinical evaluation for vascular steal. Temperature measurements were extracted from the thermograms, including bilateral arm and hand (Fistula -- Non-Fistula) differences, for comparison with derived AVF blood flow and steal grading. Derived AVF blood flow ranged from 30 to 1,950 ml min(-1), with a mean rate close to one litre per minute. Thermography detected the warmer superficial veins in proximity to the patent fistulas, with bilateral differences in fistula region skin temperature correlated with derived AVF blood flow (using maximum temperature measurements the correlation was +0.71 [p < 0.01]; and using mean temperature measurements the correlation was +0.56 [p < 0.05]). When thermography measurements were compared with the clinical assessment of steal the mean hand temperature differences separated steal from non-steal patients with an accuracy of greater than 90%. In summary, we have now demonstrated the potential clinical value of medical infrared thermography for assessing AVF function in renal patients.

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Tube Thoracostomy: A Structured Review of Case Reports and a Standardized Format for Reporting Complications

et al. 2015

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High output cardiac failure due to iatrogenic A–V fistula in scar: a report of a case and review of the literature

Cited by 4 publications

References 10 publications

High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old

High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old

Thermography and colour duplex ultrasound assessments of arterio-venous fistula function in renal patients

Tube Thoracostomy: A Structured Review of Case Reports and a Standardized Format for Reporting Complications

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