Heart Failure as a Complication of Hemodialysis Arteriovenous Fistula

  1. DANIEL J. AHEARN, M.D.; and
  2. JOHN F. MAHER, M.D.
  1. Columbia, Missouri

    Abstract

    Two patients with Brescia-Cimino fistulas had congestive heart failure. The ultrasonic flowmeter was used to measure increasing fistula flow in both patients, and Branham's sign was elicited in one. Surgical revision of the fistulas resulted in clinical improvement. Congestive heart failure may occur as a result of the surgically created arteriovenous fistula. A pronounced fall in pulse rate when the fistula has been occluded and progressive rise in fistula flow as measured by the flowmeter should alert the physician to the need for surgical revision.

    Article and Author Information

    • *United States Pharmacopeia.

    • ▸From the Division of Nephrology, Department of Medicine, University of Missouri Medical Center, Columbia, Mo.

    • Supported in part by a grant from Missouri Regional Medical Programs and grant RR00287-06, Clinical Research Center, National Institutes of Health, Bethesda, Md.

    • ▸Requests for reprints should be addressed to Daniel J. Ahearn, M.D., University of Missouri Medical Center, Department of Medicine, Division of Nephrology, Columbia, Mo. 65201.

      • Received February 17, 1972.
      • Accepted April 28, 1972.
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    1. Ann Intern Med August 1, 1972 vol. 77 no. 2 201-204
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