HIGH-OUTPUT CARDIAC-FAILURE SECONDARY TO A BRACHIOCEPHALIC ARTERIOVENOUS HEMODIALYSIS FISTULA - 2 CASES

The use of native arteriovenous fistulas for hemodialysis access is im portant to the success of this form of treatment for patients with end -stage renal disease. Native fistulas have been shown to provide impro ved longevity and to have lower complication rates where compared to p rosthetic graft fistulas. High-output cardiac failure related to hemod ialysis fistulas is an uncommon complication of their usage. Two renal transplant patients who did develop this complication from large well -developed brachiocephalic arteriovenous hemodialysis fistulas are pre sented. Both patients underwent successful transplantation and have re quired fistula ligation, with subsequent resolution of their cardiac f ailure. Native fistulas remain the best choice for hemodialysis access , but the clinician should remain aware of the possible untoward hemod ynamic effects of these fistulas.