title: From excessive high-flow, high-gradient to paradoxical low-flow, low-gradient aortic valve stenosis: hemodialysis arteriovenous fistula model.
abstract: The coexistence of aortic valve stenosis (AS) with hemodialysis arteriovenous (AV) fistula complicates the assessment of the severity of valvular disease. We describe the physiological changes in stenotic indices which occur following manual compression of the AV fistula. The manual compression of the AV fistula is capable of inducing significant alterations in transvalvular flow rates and valvulo-arterial impedance that translates into important changes in aortic valve hemodynamics and grading of stenosis severity.
authors.affiliation: Division of Cardiology and Ultrasound, Centre Hospitalier Régional et Universitaire de Lille, and EA 2693, Faculté de Médecine, Université de Lille 2, Lille, France. ennezat@yahoo.com
authors.forename: Pierre Vladimir
authors.initials: PV
authors.lastname: Ennezat
authors.forename: Sylvestre
authors.initials: S
authors.lastname: Maréchaux
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D012039:Regional Blood Flow / Q000502:physiology; D006435:Renal Dialysis; D012720:Severity of Illness Index