A case of successful treatment of chronic heart failure by reducing the blood flow in for arteriovenous fistula with spiral corrector (A case report)

Abstract

Arteriovenous fistula is the main access for chronic hemodialysis. A functioning arteriovenous access for hemodialysis is an essential hemodynamic factor that contributes to additional load on the heart. Rare long-term complication of permanent vascular access in patients receiving hemodialysis is chronic heart failure. In such cases, heart failure is characterized by a high minute cardiac output and traditional medical therapy is often not effective. In order to avoid an unfavorable outcome, surgical correction of blood flow through the arteriovenous fistula is required. The article provides a brief overview and analysis of existing surgical techniques for the treatment of excessive shunt of blood flow into the right atrium in patients receiving hemodialysis with clinical manifestations of chronic heart failure. The authors propose a new surgical method of the correction of excessive blood flow in the fistulas without the disadvantages of known ones. The effectiveness of this method was assessed using studies of cardiac hemodynamics and blood flow in the vessels by echocardiography and color Doppler mapping. Our attention was focused on the anatomical and functional state of the arterial and venous segments of an arteriovenous fistula. The amount of shunt blood flow before and after surgery was measured.