title: Right Heart Catheterization via Dialysis Arteriovenous Shunts in End-Stage Renal Disease Patients.
abstract: OBJECTIVE
  Right heart catheterization is an important diagnostic tool but carries risks of adverse events. Little is known about the feasibility and safety of using dialysis arteriovenous (AV) shunts. We aim to evaluate the feasibility and safety of using dialysis AV shunts for access in right heart catheterization.
  
  
  METHODS
  Hemodialysis patients who required right heart catheterization were prospectively enrolled. A 7 Fr sheath was inserted and a balloon-tipped pulmonary artery catheter was advanced for right heart catheterization. Patients were followed for 1 month, and technical success, procedure details, and complications were recorded.
  
  
  RESULTS
  Thirteen patients received right heart catheterization via AV shunts. Three patients were evaluated for heart failure, and 10 were examined for pulmonary hypertension. Median patient age was 69 years (interquartile range [IQR], 58-77 years), and median shunt age was 50 months (IQR, 32-75 months). Five shunts were located in the upper arm, 2 were in the right arm, and 5 were native fistulas. All AV shunt punctures were successful on the first attempt. All right heart catheterizations were completed via AV shunts, and the technical success rate was 100%. Median fluoroscopy time was 6.9 minutes. No venous access complications or right heart catheterization-related complications occurred immediately after the procedure or during the 1-month follow-up period.
  
  
  CONCLUSIONS
  AV dialysis shunts can be used for venous access for right heart catheterization with acceptable feasibility and patient tolerability. Further randomized studies are needed to confirm the benefits of this approach compared with other approaches.
authors.forename: Mu-Yang
authors.initials: MY
authors.lastname: Hsieh
authors.forename: Tsung-Yan
authors.initials: TY
authors.lastname: Chen
authors.forename: Lin
authors.initials: L
authors.lastname: Lin
authors.forename: Min-Tsun
authors.initials: MT
authors.lastname: Liao
authors.forename: Ren-Huei
authors.initials: RH
authors.lastname: Wang
authors.forename: Ruei-Cheng
authors.initials: RC
authors.lastname: Kuo
authors.forename: Chao-Lun
authors.initials: CL
authors.lastname: Lai
authors.affiliation: Cardiovascular Center, National Taiwan University Hospital Hsinchu Branch, Taiwan, National Taiwan University, College of Medicine, Taiwan, No. 25, Lane 442, Sec. 1, Jingguo Rd, Hsinchu City 300, Taiwan. chihchengwumd@gmail.com.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Wu
mesh_terms: D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods*; D002406:Catheterization, Peripheral / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011651:Pulmonary Artery / Q000601:surgery; D006435:Renal Dialysis / Q000379:methods; D013624:Taiwan