Arteriovenous fistula
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| ICD-10 | I28.0, I77.0 |
|---|---|
| ICD-9 | 414.19, 417.0, 447.0, 747.3 |
An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. They may be congenital, or acquired due to trauma or erosion of an arterial aneurism. Patients with end stage renal failure treated with hemodialysis often have a fistula surgically created in their arm (called a Cimino fistula) to allow the frequent needle punctures needed to get blood out of, and back into, the body for dialysis.
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[edit] Pathophysiology
When an arteriovenous fistula is formed involving a major artery like the abdominal aorta, it can lead to a large decrease in peripheral resistance. This lowered peripheral resistance causes the heart to increase cardiac output in order to maintain proper blood flow to all tissues. The physical manifestations of this would be a relatively normal systolic blood pressure with a decreased diastolic blood pressure resulting in a wide pulse pressure.
[edit] Treatment
Congenital fistulas usually don't need treatment. Acquired fistulas can be treated by surgery.
[edit] See also
[edit] External links
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