Surgical correction of high fistula flow can resolve high-output congestive heart failure in hemodialysis patients.
May warrant fistula revision in refractory high-output HF on dialysis; leaves open need for prospective studies.
Hemodialysis fistulas are a cause of high-output congestive heart failure (CHF). A case is reviewed of a patient in whom surgical correction of an excessively high fistula flow led to resolution of CHF. Bradycardia induced by fistula occlusion (Nicaladoni-Branham sign) was not present, but transient occlusion did produce a marked decrease in cardiac output.
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Reis et al. (1988) studied this question.
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