INFLUENCE OF BLOOD FLOW VOLUME ALONG THE ARTERIOVENOUS FISTULA ON THE SIZES OF THE RIGHT HEART CHAMBERS IN PATIENTS ON PROGRAM HEMODIALYSIS

THE AIM of the investigation was to assess changes to the right heart chambers depending on the blood flow along arteriovenous fistulas of different localization as a permanent vascular access in patients treated by hemodialysis. PATIENTS AND METHODS. Echocardiographic and dopplerographic examinations were carried out in 62 patients with chronic renal failure (CRF), treated by hemodialysis. RESULTS. Convincing data were obtained concerning the influence of the shunt blood flow along the arteriovenous fistulas on changes to the right heart chambers, size and rated pressure in the pulmonary artery, as well as intensity of the clinical picture of heart failure. For possible correction of the appearing alterations five reconstructive operations were performed followed by distinct positive dynamics including decreased shunt blood flow and echocardiographic sizes of the right heart chambers. CONCLUSION. The work resulted in determination of the volume of optimal blood flow (500 ml/min or 5% of the heart output) and indications for operative interventions on the present anastomosis (greater sizes of the right auricle > 50 mm, shunt blood flow > 1000 ml/min or 10% of the cardiac output).

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