Consequences of Creation of Arteriovenous Fistula

Meyer, A.

doi:10.1001/jama.1963.03700210045007

Cited by 9 publications

(1 citation statement)

References 2 publications

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“…According to the investigations of Rowntree and Brown [26], H olman [9] as well as Warren et al [36], the circulating blood volume significantly increases in the presence of arteriovenous fistula [1,6,13,17,20,21,27,31]. The greater part of authors agree that after closing the arteriovenous fistula the previously high cardiac output decreases significantly [1,13,17,27]. It would be interesting to know -from the point of view of the regulation of circulation -how the blood circulation of other organs is altered by the influence of an extensive arteriovenous shunt.…”

Section: Discussionmentioning

confidence: 99%

Haemodynamic Changes of Systemic and Limb Circulation in Extremital Arteriovenous Fistula

Solti¹,

Soltész²,

E³

1972

J Vasc Res

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The regulation of limb and systemic blood circulation was studied in 12 extensive lower extremital and 8 extensive upper extremital arteriovenous shunts. The limb blood flow was determined by the venous isotope dilution method. The cardiac output and the mean transit time were measured by the dye dilution method. Measurements to determine the limb blood flow were made on the side of the arteriovenous shunt as well as on the contralateral (healthy) side. The results of the measurements were compared with the data of patients having an intact circulation. According to these investigations, the limb blood flow nearly triples the normal value under the influence of extremital arteriovenous fistula. Nevertheless, the limb blood flow of the contralateral (healthy) extremity is also in a small degree – but significantly – higher than the normal flow. According to the arteriovenous fistula, the extremital cardiac output fraction is higher than the normal value, while, in the same time, in the healthy, contralateral extremity it is smaller. The arteriovenous oxygen difference in arteriovenous fistula is pathologically low, while the total oxygen uptake of extremital tissues is normal. The blood circulation assumes a hyperkinetic character under the influence of arteriovenous shunt: the cardiac output increases, the velocity of circulation accelerates, the total systemic vascular resistance diminishes. Following the operative elimination or ceasing of the arteriovenous shunt, the changes of circulation mostly regress. According to the calculations made by the authors, the blood flow perfusing through the fistula in an extensive arteriovenous shunt might have been some liters per minute.

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