Native arteriovenous fistula placement in three patients after implantation of a left ventricular assist device with non‐pulsatile blood flow

Schaefers, Johannes Frederik; Ertmer, Christian

doi:10.1111/hdi.12533

Cited by 15 publications

(11 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Definition and classification of cardiorenal syndromes (28) Cardiorenal syndromes general definition: Disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. the AVFs functioned well (41). In our opinion, AVFs can be used successfully in patients with continuous flow LVADs.…”

Section: Second Can Arteriovenous Fistulas Mature Without Pulsatile mentioning

confidence: 55%

Left Ventricular Assist Devices and the Kidney

Ross

Stevens²,

Wanchoo

et al. 2017

CJASN

View full text Add to dashboard Cite

Left ventricular assist devices (LVADs) are common and implantation carries risk of AKI. LVADs are used as a bridge to heart transplantation or as destination therapy. Patients with refractory heart failure that develop chronic cardiorenal syndrome and CKD often improve after LVAD placement. Nevertheless, reversibility of CKD is hard to predict. After LVAD placement, significant GFR increases may be followed by a late return to near baseline GFR levels, and in some patients, a decline in GFR. In this review, we discuss changes in GFR after LVAD placement, the incidence of AKI and associated mortality after LVAD placement, the management of AKI requiring RRT, and lastly, we review salient features about cardiorenal syndrome learned from the LVAD experience. In light of the growing number of patients using LVADs as a destination therapy, it is important to understand the effect of these devices on the kidney. Additional research and long-term data are required to better understand the relationship between the LVAD and the kidney.

show abstract

Section: Second Can Arteriovenous Fistulas Mature Without Pulsatile mentioning

confidence: 55%

Left Ventricular Assist Devices and the Kidney

Ross

Stevens²,

Wanchoo

et al. 2017

CJASN

View full text Add to dashboard Cite

show abstract

“…Arteriovenous hemodialysis accesses, which divert a significant portion of the cardiac output from systemic perfusion and have been implicated in high‐output HF, have been a cause for concern, both in terms of whether maturation would occur for arteriovenous fistulas, and whether systemic perfusion would remain adequate 33, 34. Recent case reports have described successful arteriovenous fistulas maturation in hemodialysis patients with LVADs 35, 36. A large proportion of our patients had arteriovenous accesses at time of VAD implantation, but we were unable to investigate outcomes related to dialysis access because of limited numbers.…”

Section: Discussionmentioning

confidence: 99%

Implantable Ventricular Assist Device Use and Outcomes in People With End‐Stage Renal Disease

Walther

Niu

Winkelmayer

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundPeople with end‐stage renal disease (ESRD) are at risk for advanced heart failure, but little is known about use and outcomes of durable mechanical circulatory support in this setting. We examined use and outcomes of implantable ventricular assist devices (VADs) in a national ESRD cohort.Methods and ResultsWe performed a retrospective cohort study of Medicare beneficiaries with ESRD who underwent implantable VAD placement from 2006 to 2014. We examined in‐hospital and 1‐year mortality, all‐cause and cause‐specific hospitalizations, and heart/kidney transplantation outcomes. We investigated as predictors demographic factors, time‐period of VAD implantation, primary or post‐cardiotomy implantation, and duration of ESRD before VAD implantation. We identified 96 people with ESRD who underwent implantable VAD placement. At time of VAD implantation, 74 (77.1%) were receiving hemodialysis, 10 (10.4%) were receiving peritoneal dialysis and 12 (12.5%) had renal transplant. Time from incident ESRD to VAD implantation was median 4.0 (interquartile range 1.1, 8.2) years. Mortality during the implantation hospitalization was 40.6%. Within 1 year of implantation 61.5% of people had died. On multivariable analysis, males had half the mortality risk of females. Lower mortality risk was also seen with VAD implantation in a primary setting, and with more recent year of implantation, but these results did not reach statistical significance.ConclusionsMedicare beneficiaries with ESRD are undergoing durable VAD implantation, often several years after incident ESRD, although in low numbers. Mortality is high among these patients, highlighting the need for investigations to improve treatment selection and management.

show abstract

“…6 While the lack of pulsatility was theorized to lead to uncertainty of fistula maturation in the setting of continuous flow support, several authors have reported long-term success in this setting with excellent AVF maturation for use in dialysis. [8][9][10] Now, Hair and colleagues 7 also confirm that AVF can be successfully matured in a circulation supported by a TAH with mechanically induced pulsatile flow. It is, however, important to note that the shunt created by a mature AVF may reach 600 to 1200 mL/min, 4 and the risk of elevating pulmonary vascular resistance should be factored into the decision to pursue an AVF in a bridge-to-transplant candidate.…”

mentioning

confidence: 87%