Premium
Dramatic Improvement in Decompensated Right Heart Failure due to Severe Tricuspid Regurgitation Following Ligation of Arteriovenous Fistula in a Renal Transplant Recipient
Author(s) -
Rao Nitesh,
Worthley Matthew,
Disney Patrick,
Faull Randall
Publication year - 2014
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12145
Subject(s) - medicine , cardiology , arteriovenous fistula , heart failure , ligation , regurgitation (circulation) , hemodialysis , cardiac output , fistula , hemodynamics , surgery
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.