Acute systemic hypotension after arteriovenous fistula construction in a patient with severe aortic stenosis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Naobumi Mise Lisa Uchida Mototsugu Tanaka Shinji Tanaka Hiroyoshi Nakajima Tokuichiro Sugimoto
- چاپ و سال / کشور: 2011
Description
We report the case of a 53-year-old hemodialysis patient with severe aortic stenosis, who developed acute systemic hypoperfusion after arteriovenous fistula (AVF) construction. He presented with hypotension and repeated syncope soon after distal radiocephalic AVF construction, and finally developed a respiratory arrest. His blood pressure and hemodynamics recovered promptly by sub-emergent aortic valve replacement surgery. In the present case, the heart with severe aortic stenosis could not increase cardiac output in response to the reduction in peripheral vascular resistance caused by the AVF. Highoutput heart failure, a relatively rare AVF-associated disorder, occurs with an excessive AVF flow, usually more than 3 L/min or 30% of cardiac output. However, heart failure may develop soon after construction of an AVF with a moderate blood flow if a patient’s cardiac function is severely impaired. In addition, heart failure may improve with AVF preservation if the underlying heart disease is treatable.
Clin Exp Nephrol DOI 10.1007/s10157-011-0484-3 Received: 7 January 2011 / Accepted: 13 June 2011
