title: Dramatic improvement in decompensated right heart failure due to severe tricuspid regurgitation following ligation of arteriovenous fistula in a renal transplant recipient.
abstract: Arteriovenous (AV) fistulas with high blood flow rate are necessary for adequate hemodialysis, but they can also cause significant hemodynamic changes, including raised cardiac output, left ventricular hypertrophy and occasionally overt cardiac failure (Basile et al., Nephrol Dial Transplant, 23, 2008, 282; Unger et al., Am J Transplant, 4, 2004, 2038). We now report a case of rapid and dramatic improvement in symptomatic right heart failure due to severe tricuspid regurgitation following ligation of an arteriovenous fistula. Cardiac magnetic resonance imaging (MRI) performed before and after the ligation of fistula showed striking improvement in both the tricuspid regurgitation and right ventricular dimensions, with minimal impact on left ventricular mass, size, and function.
authors.affiliation: Division of Nephrology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Nitesh
authors.initials: N
authors.lastname: Rao
authors.forename: Matthew
authors.initials: M
authors.lastname: Worthley
authors.forename: Patrick
authors.initials: P
authors.lastname: Disney
authors.forename: Randall
authors.initials: R
authors.lastname: Faull
mesh_terms: D000368:Aged; D001166:Arteriovenous Shunt, Surgical; D006333:Heart Failure / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D016030:Kidney Transplantation; D008026:Ligation; D008297:Male; D006435:Renal Dialysis; D012720:Severity of Illness Index; D014262:Tricuspid Valve Insufficiency / Q000150:complications*