Heart failure necessitating left ventricular assist device (LVAD) support can lead to kidney failure requiring dialysis. Some of these patients may require long-term hemodialysis (HD). Optimal vascular access for a patient on long-term HD therapy with an LVAD remains a complex issue. The majority of LVADs are of the continuous-flow type, and it has been theorized that native arteriovenous fistula maturation may be impaired in a setting of decreased pulsatile arterial flow. We describe a case of successful creation and use of an arteriovenous fistula in an HD-dependent patient with a continuous-flow LVAD.
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| http://dx.doi.org/10.1053/j.ajkd.2016.07.032 | DOI Listing |
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