From excessive high-flow, high-gradient to paradoxical low-flow, low-gradient aortic valve stenosis: hemodialysis arteriovenous fistula model

Pierre Vladimir Ennezat; Sylvestre Maréchaux; Philippe Pibarot

doi:10.1159/000314938

From excessive high-flow, high-gradient to paradoxical low-flow, low-gradient aortic valve stenosis: hemodialysis arteriovenous fistula model

Cardiology. 2010;116(1):70-2. doi: 10.1159/000314938. Epub 2010 May 26.

Authors

Pierre Vladimir Ennezat¹, Sylvestre Maréchaux, Philippe Pibarot

Affiliation

¹ Division of Cardiology and Ultrasound, Centre Hospitalier Régional et Universitaire de Lille, and EA 2693, Faculté de Médecine, Université de Lille 2, Lille, France. [email protected]

PMID: 20502013
DOI: 10.1159/000314938

Abstract

The coexistence of aortic valve stenosis (AS) with hemodialysis arteriovenous (AV) fistula complicates the assessment of the severity of valvular disease. We describe the physiological changes in stenotic indices which occur following manual compression of the AV fistula. The manual compression of the AV fistula is capable of inducing significant alterations in transvalvular flow rates and valvulo-arterial impedance that translates into important changes in aortic valve hemodynamics and grading of stenosis severity.

Publication types

Case Reports

MeSH terms

Aged
Aortic Valve Stenosis / complications*
Aortic Valve Stenosis / diagnostic imaging
Aortic Valve Stenosis / physiopathology*
Arteriovenous Shunt, Surgical / adverse effects*
Echocardiography, Doppler
Female
Humans
Kidney Failure, Chronic / complications*
Kidney Failure, Chronic / therapy*
Regional Blood Flow / physiology
Renal Dialysis*
Severity of Illness Index