Abstract
Postoperative renal dysfunction necessitating hemodialysis after implantation of ventricular assist devices presents a challenge with respect to establishment of hemodialysis access. Lack of pulsatile flow has led to concerns that arteriovenous fistulas will not mature. This study aims to evaluate arteriovenous fistula as a method of hemodialysis. Consecutive patients who underwent implantation of a ventricular assist device between 1988 and 2016 with a subsequent need for hemodialysis were identified. Retrospective data were collected for patients requiring hemodialysis through an arteriovenous fistula or arteriovenous graft. Access flow rates and duration of patency are reported. Sixty-four patients were identified (10 required long-term hemodialysis, 5 via arteriovenous fistula, 1 via arteriovenous graft). All six patients receiving long-term hemodialysis access were on continuous-flow ventricular assist devices. Brachiocephalic arteriovenous fistulas were performed in all arteriovenous fistula patients, and the average preoperative vein diameter was 4.1 ± 0.9 mm. On 30-day follow-up, the average flow rate was 1262 ± 643 mL/min (880-2220). In arteriovenous fistula patients, one died at 30 days, one arteriovenous fistula requ...Continue Reading
References
Jan 17, 2002·The New England Journal of Medicine·E A RoseUNKNOWN Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group
Nov 7, 2003·Journal of Vascular Surgery·Thomas S HuberJames M Seeger
Apr 30, 2008·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Sigrid E SandnerGeorg M Wieselthaler
Mar 28, 2009·The Annals of Thoracic Surgery·Sigrid E SandnerGeorg M Wieselthaler
Jun 6, 2009·Journal of Vascular Surgery·Lannery S LauvaoJoseph L Mills
Oct 16, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Ami M PatelMichael R Rudnick
Apr 22, 2014·Journal of Vascular and Interventional Radiology : JVIR·Talia SassonDavid L Waldman
Mar 15, 2015·Journal of Vascular Surgery·Andrew E LeakeMichel S Makaroun
Dec 15, 2015·The Journal of Vascular Access·Jared M CriddleWilliam S Rilling
Oct 4, 2016·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Andrew I ChinJohn P McVicar
Jan 5, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M ColvinB L Kasiske
Jan 10, 2017·Hemodialysis International·Johannes F Schaefers, Christian Ertmer
Jul 1, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Duc B NguyenPriti R Patel