How does AV fistula cause heart failure?

How does AV fistula cause heart failure?

When a large proportion of arterial blood is shunted from the left-sided circulation to the right-sided circulation via the fistula, the increase in preload can lead to increased cardiac output. Over time, the demands of an increased workload may lead to cardiac hypertrophy and eventual heart failure.

What is reflex sympathetic dystrophy of the lower limb?

What is Reflex Sympathetic Dystrophy (RSD) Syndrome? RSD is an older term used to describe one form of Complex Regional Pain Syndrome (CRPS). Both RSD and CRPS are chronic conditions characterized by severe burning pain, most often affecting one of the extremities (arms, legs, hands, or feet).

Does AV fistula affect heart?

The current literature suggests that the creation of AVF can cause or exacerbate the following conditions: congestive heart failure, left ventricular hypertrophy, pulmonary hypertension, right ventricular dysfunction, coronary artery disease, and valvular dysfunction.

What is steal syndrome of an AV fistula?

Abstract. Ischemic steal syndrome (ISS) is a complication that can occur after the construction of a vascular access for hemodialysis. It is characterized by ischemia of the hand caused by marked reduction or reversal of flow through the arterial segment distal to the arteriovenous fistula (AVF).

Do AV fistula increased cardiac output?

Creation of a hemodialysis arteriovenous (AV) access (via constructed native AV fistula or a prosthetic AV graft) causes an acute decrease in systemic vascular resistance and a secondary increase in cardiac output [1,2].

Can you have surgery if you have RSD?

Surgery on extremities suffering from reflex sympathetic dystrophy (RSD) is generally avoided because it is presumed that RSD will recur or worsen.

What happens if you take a blood pressure on an arm with a fistula?

Don’t use the fistula to administer I.V. fluids, which could compromise its integrity and patency. Don’t take blood pressure readings or perform venipuncture on the access arm. These procedures could contribute to infection and clotting in the fistula.

How is AVF steal syndrome diagnosed?

The diagnosis of steal is based on an accurate history and physical examination and confirmed with tests including an arteriogram, duplex Doppler ultrasound (DDU) evaluation with finger pressures and waveform analysis. Treatment of steal includes observation of developing symptoms in mild cases.

What causes steal syndrome AV fistula?

Ischemic steal syndrome (ISS) is a complication that can occur after the construction of a vascular access for hemodialysis. It is characterized by ischemia of the hand caused by marked reduction or reversal of flow through the arterial segment distal to the arteriovenous fistula (AVF).

Why does AV fistula increase preload?

An arteriovenous fistula can increase preload. AV shunts also decrease the afterload of the heart. This is because the blood bypasses the arterioles which results in a decrease in the total peripheral resistance (TPR). AV shunts increase both the rate and volume of blood returning to the heart.

How does an AV fistula decrease SVR?

AV fistula decreases systemic vascular resistance and blood pressure. The fall in blood pressure augments central sympathetic outflow and increases the concentration of circulating angiotensin II, aldosterone, and arginine vasopressin (AVP).

What is the most common cause of maturation failure of dialysis access fistula?

Failure to Mature: One of the most common causes of failed maturation is due to anastomotic stricture caused by neointimal hyperplasia. Stricture is defined as a greater than 50% decrease in the luminal diameter of the outflow vein.