Systemic arteriovenous fistulae for end-stage cyanosis after cavopulmonary connection: a useful bridge to transplantation

The Journal of Thoracic and Cardiovascular Surgery
Edward J HickeyW G Williams

Abstract

Intractable cyanosis after partial or complete cavopulmonary connection may rarely be managed by creating a systemic arteriovenous fistula. We investigated the long-term performance of arteriovenous fistulae. All 21 patients who received an arteriovenous fistula at The Hospital for Sick Children since the 1950s were investigated using parametric competing risk techniques. Primary arteriovenous fistula indication was (1) suboptimal pulmonary blood flow (N = 15) or (2) pulmonary shunting via pulmonary arteriovenous malformations (N = 6). Arteriovenous fistula longevity was determined by time to "occlusion" (absence of arteriovenous fistula flow via surgical ligation or spontaneous occlusion). All 21 patients had previously undergone second-stage palliation (Glenn shunt = 13; bidirectional shunt = 9). Five patients had undergone Fontan completion. Death in the presence of a functioning arteriovenous fistula occurred in 5 patients. Patients with bidirectional shunts had a significantly higher risk of death with a functioning arteriovenous fistula in situ (P = .04). High hemoglobin concentrations were associated with best outcome, and levels less than 170 g/L were associated with a high risk of death despite a functioning arterioven...Continue Reading

References

Jul 1, 1969·British Heart Journal·M SamánekM Vorísková
Jan 1, 1984·The Annals of Thoracic Surgery·W W Glenn
Jan 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·A MageeR M Freedom
Apr 4, 1998·The Annals of Thoracic Surgery·J LeeH C Rosenberg
Apr 24, 1999·The Annals of Thoracic Surgery·A R MottN D Bridges
May 29, 2003·The Journal of Thoracic and Cardiovascular Surgery·David A AshburnEugene H Blackstone
Oct 7, 2004·Journal of the American College of Cardiology·David Michael McMullanRobert Kirk Riemer
Jun 25, 2005·The Annals of Thoracic Surgery·Gonzalo E UrcelayMaria E Castillo

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Citations

Aug 6, 2013·Current Treatment Options in Cardiovascular Medicine·Ari CedarsPhilip Ludbrook
May 6, 2015·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Fabrizio De RitaAsif Hasan
Apr 15, 2015·World Journal for Pediatric & Congenital Heart Surgery·Nitin ChananaPhillip T Burch
Jan 10, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ivan A YurlovTatyana V Mataeva
Jul 11, 2020·Seminars in Cardiothoracic and Vascular Anesthesia·Ray S ChoiMorgan L Brown
Apr 25, 2014·Expert Review of Cardiovascular Therapy·Minoo N KavaranaRupak Mukherjee
Feb 16, 2021·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Sachin TalwarBalram Airan
Mar 9, 2021·Annals of Pediatric Cardiology·Ibrahim J AlibrahimFahad Alhabshan
May 11, 2020·Seminars in Thoracic and Cardiovascular Surgery·Andrew D SpearmanRamani Ramchandran

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