AVF Occlusion Unveils True Hemodynamics

BACKGROUND: High-flow hemodialysis arteriovenous fistulas (AVFs) can augment measured cardiac output and confound transplant hemodynamic assessment. CASE SUMMARY: , pulmonary artery oxygen saturation from 65% to 49%, and cardiac power output from 0.78 to 0.58 W. DISCUSSION: Duplex-confirmed AVF occlusion demonstrated that baseline cardiac output and pulmonary vascular indices were shunt-dependent, unmasking low-output physiology not appreciated with subjective occlusion. TAKE-HOME MESSAGE: Hemodynamics may be misleading unless AVF occlusion is complete and verified during right heart catheterization.