July 1, 2019Advances in Pulmonary HypertensionOpen Access

Despite AVF ligation and multiple pulmonary vasodilator therapies, the patient's pulmonary hypertension and symptoms progressed, ultimately leading to death.

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Population

A 74-year-old male with ESRD on hemodialysis presenting with dyspnea

Design

Case report

Authors

AGAbhinav Gupta CDChristine Dillingham HFHarrison W. Farber

Discussion

Member takes

Overview

Refractory PH despite AVF ligation and vasodilators in ESRD cautions clinicians; leaves open optimal management strategies and need for prospective data.

Structured PICO

Population

A 74-year-old male with end-stage renal disease (ESRD) on hemodialysis via left upper extremity arteriovenous fistula (AVF), presenting with dyspnea (NYHA class III) and pulmonary hypertension.

Intervention

Surgical ligation of AVF and sequential pulmonary vasodilator therapy (sildenafil, macitentan, selexipag, epoprostenol).

This case highlights the complexity of diagnosing and managing pulmonary hypertension in ESRD patients with AV fistulas, where high cardiac output and intrinsic pulmonary vascular disease may coexist and be refractory to standard therapies.

Cite This Study

Gupta et al. (2019) studied this question.

synapsesocial.com/papers/6a89cdb41c70e695d84345ce https://doi.org/10.21693/1933-088x-18.2.70

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July 1, 2019Advances in Pulmonary HypertensionOpen Access

Despite AVF ligation and multiple pulmonary vasodilator therapies, the patient's pulmonary hypertension and symptoms progressed, ultimately leading to death.

View Full Paper

Ask AI

Bookmark

Population

A 74-year-old male with ESRD on hemodialysis presenting with dyspnea

Design

Case report

Authors

AGAbhinav Gupta CDChristine Dillingham HFHarrison W. Farber

Discussion

Member takes

Overview

Refractory PH despite AVF ligation and vasodilators in ESRD cautions clinicians; leaves open optimal management strategies and need for prospective data.

Structured PICO

Population

A 74-year-old male with end-stage renal disease (ESRD) on hemodialysis via left upper extremity arteriovenous fistula (AVF), presenting with dyspnea (NYHA class III) and pulmonary hypertension.

Intervention

Surgical ligation of AVF and sequential pulmonary vasodilator therapy (sildenafil, macitentan, selexipag, epoprostenol).

Cite This Study

Gupta et al. (2019) studied this question.

synapsesocial.com/papers/6a89cdb41c70e695d84345ce https://doi.org/10.21693/1933-088x-18.2.70

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