医学
动静脉瘘
心脏病学
肱动脉
内科学
肾移植
血流
移植
肾
心脏移植物血管病
心输出量
血流动力学
外科
心脏移植
血压
作者
J. Janečková,P. Bachleda,P. Utíkal
出处
期刊:Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
[Chirurgie-Servis z.s]
日期:2022-05-15
卷期号:101 (5)
被引量:1
标识
DOI:10.33699/pis.2022.101.5.227-231
摘要
Cardiovascular disease is the most frequent cause of death in kidney transplant patients. High-flow arteriovenous fistula (AVF) increases cardiac output and may contribute to hyperkinetic heart failure. AVF follow-up is not implemented in kidney transplant patients. The aim of this study was to reduce AVF blood flow in a group of patients with a high-flow AVF following kidney transplantation to reduce cardiac strain.This prospective study was performed in kidney transplant patients who had a vascular access created before transplantation. The AVF of these patients was examined by ultrasound with a focus on AVF flow and brachial artery size. If high-flow AVF was detected, flow reduction was performed in the indicated group of patients.The study examined 164 patients, of whom 24 had a hyperfunctional AVF (14.8%). A total of 16 AVF flow reductions were performed, which led to an average decrease in cardiac index by 0.77 L/min/m2. Primary patency of the reconstructions was 93.33% after 12 months. All patients experienced a subjective improvement in dyspnea.Reduction in AVF flow leads to an improvement in the quality of life of kidney transplant patients. Maintaining a functional AVF is beneficial, especially for patients after repeated surgeries, where the option of creating an autologous AVF is limited.
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