Development of high-output heart failure after correction of central venous occlusion

International Conference and Exhibition on Nephrology & Therapeutics

August 20-22, 2012 Hilton Chicago/Northbrook, USA

Mehmet Horoz, Turkay Ozcan, Altan Yildiz, Ebru Gok Oguz, Ahmet Kiykim and Kenan Turgutalp

Accepted Abstracts: J Nephrol Therapeut

Abstract :

C entral venous catheter (CVC) insertion has been performed frequently for hemodialysis (HD) in HD patients. One of the most important long-term complications of CVC is the central venous occlusion (CVO). HD patients with arteriovenous fistula (AVF) and without a previous history of a central venous catheterization may also develop CVO. Case: A 69-year-old female patient was admitted to our hospital with complaint of swelling, pain, and severe venous collateral on her left arm and hemithorax. Her past medical history revealed the diagnosis of diabetes mellitus and hypertension for 20 years. Seven years earlier, she experienced unclassified acute renal failure and received HD treatment initially via left internal jugular CVC for 28 days and then via AVF created on left radial snuff box for 3 months. After this period, as her renal functions recovered, HD treatment was no longer needed. After initial evaluation, fistulography was performed and left brachiocephalic vein occlusion was detected. During fistulography, PTA and stent implantation was performed successfully. Two hours after the procedure, the patient experienced acute respiratory distress. Her physical examination revealed bilateral jugular venous distention, bilateral crackles at the lower fields of the lung, and tachycardia. Chest X-ray revealed pulmonary edema. In conclusion, it should be kept in the mind that treatment of CVO with serious venous congestion may result in the development of acute high-output heart failure (HOHF). Before the revascularization procedure, cardiac functions and factors associated with the development of acute HOHF should be evaluated carefully in patients with CVO. Furthermore, reporting of the post-procedural acute complications will improve the awareness and preventive measures.