Sudden death after arteriovenous fistula ligation in a renal transplant patient.
After a period of time using an arteriovenous (AV) fistula as vascular access for hemodialysis, kidney transplant recipients usually undertake surgical closure if the fistula is not spontaneously closed. In all prospective studies addressing this issue, absence of major adverse events and progressive decrease in left ventricular volume and mass is the rule. However, in these studies, patients with heart failure New York Heart Association (NYHA) III or IV were not included, and consequently, the effects of AV ligation in these high-risk patients are not well known. We present a heart failure NYHA IV renal transplant patient with fatal evolution after surgical closure of her high-flow AV fistula.
Pascual
Julio
J
Department of Nephrology, Hospital Ramón y Cajal, Madrid, Spain. jpascual.hrc@salud.madrid.org
Martins
Judith
J
Bouarich
Hannane
H
Galeano
Cristina
C
Barrios
Vivencio
V
Marcén
Roberto
R
Ortuño
Joaquín
J
D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D016534:Cardiac Output, High / Q000150:complications* / Q000209:etiology; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D016030:Kidney Transplantation; D008026:Ligation; D008875:Middle Aged; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D012720:Severity of Illness Index