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Heart Failure as a Complication of Hemodialysis Arteriovenous Fistula

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Supported in part by a grant from Missouri Regional Medical Programs and grant RR00287-06, Clinical Research Center, National Institutes of Health, Bethesda, Md.

▸Requests for reprints should be addressed to Daniel J. Ahearn, M.D., University of Missouri Medical Center, Department of Medicine, Division of Nephrology, Columbia, Mo. 65201.

Columbia, Missouri

Ann Intern Med. 1972;77(2):201-204. doi:10.7326/0003-4819-77-2-201
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Two patients with Brescia-Cimino fistulas had congestive heart failure. The ultrasonic flowmeter was used to measure increasing fistula flow in both patients, and Branham's sign was elicited in one. Surgical revision of the fistulas resulted in clinical improvement. Congestive heart failure may occur as a result of the surgically created arteriovenous fistula. A pronounced fall in pulse rate when the fistula has been occluded and progressive rise in fistula flow as measured by the flowmeter should alert the physician to the need for surgical revision.





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