Hemodynamic effects of closure of residual arteriovenous fistulae during in situ graft procedures.
The objective was to study the intraoperative hemodynamic effects of closure of residual arteriovenous fistulae during in situ saphenous vein graft procedures. Data on 60 residual arteriovenous fistulae in nine patients (five men) with a median age of 74 years (range 64-83 years) with critical lower limb ischemia were obtained. Direct measurements of proximal and distal blood pressures in the graft were taken and simultaneous determinations of volume blood flow proximally and distally in the graft with ultrasound transit time technique before and after closure of residual fistulae were made. Closure of a fistula with blood flow around or below 100 mL/min did not increase distal outflow, whereas closure of fistulae with higher blood flow resulted in unpredictable changes in distal outflow. Only fistulae with a blood flow above approximately 100 mL/min may be of hemodynamic significance.
Laustsen
Jesper
J
Department of Cardiothoracic and Vascular Surgery T, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, Aarhus N, Denmark. laustsen@dadlnet.dk
Nielsen
Henriette Svarre
HS
Pedersen
Erik Morre
EM
Paaske
William P
WP
D000368:Aged; D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D003718:Denmark; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D016896:Treatment Outcome; D014463:Ultrasonography