HEMODYNAMIC ABNORMALITIES IN DIFFERENT KIND OF ARTERIOVENOUS ACCESS FOR HEMODIALYSIS

• Main Authors: V. M. Sedov, S. V. Alfyorov, S. A. Karpov, K. M. Grinyov
• Format: Article
• Language: Russian
• Published: Pavlov First Saint Petersburg State Medical University 2018-01-01
• Series: Вестник хирургии имени И.И. Грекова
• Subjects: гемодиализ; гемодинамика; артериовенозный доступ; перманентный туннельный катетер; хроническая сердечная недостаточность; hemodialysis; hemodynamics; arteriovenous access; permanent tunnel catheter
• Online Access: https://www.vestnik-grekova.ru/jour/article/view/681

On the basis of examination of 35 dialytic patients, who had clinical findings of progressed chronic cardiac insufficiency against the background of the large arteriovenous shunt through existing vascular access, the authors show the complications. The volume of blood circulation along the arteriovenous fistula, which was more than 30% of cardiac output, caused dilatation of heart cavities with cardiac decompensation. If the largest potency to volume remodeling of native proximal arteriovenous fistulas is taken into account, this kind of access could cause hemodynamic abnormalities more often than others (in 22 (62.9%) of patients). The best primary survival was demonstrated by arteriovenous shunts (87.1%) during 2 years. However, long-term survival of native arteriovenous fistulas dramatically outperformed the other kinds of accesses. The choice of constant vascular access for hemodialysis is an important and difficult task in chronic renal disease of V degree patients.