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February 1970

Influence of the Liver on Arteriovenous Fistulas

Author Affiliations

Lexington, Ky
From the Department of Surgery, University of Kentucky College of Medicine, Lexington.

Arch Surg. 1970;100(2):154-156. doi:10.1001/archsurg.1970.01340200042010

An abnormal communication between the peripheral arterial and venous systems produces typical hemodynamic effects of increased cardiac output, hypervolemia, and eventual heart failure. These changes are not seen following a splanchnic arteriovenous fistula. Cardiac output, measured before and after closure of a splanchnic arteriovenous fistula in one patient, showed no significant change. The absence of hemodynamic effects in this situation has been attributed to the resistance of the liver positioned between the heart and the fistula. However, experimental proof of this assumed "hepatic protection" is lacking. This investigation was designed to study the effect of interposing the liver between the heart and a peripheral arteriovenous fistula.

Methods and Materials  Fifteen mongrel dogs were used in this experiment. After an overnight fast, they were anesthetized with intravenously administered thiopental sodium and placed on a piston-type mechanical respirator. Hartmann's solution was infused intravenously at a rate of 50 ml/hr except when additional

Reid, M.R.:  The Effect of Arteriovenous Fistula Upon the Heart and Blood Vessels: An Experimental and Clinical Study , Bull Johns Hopkins Hosp 31:43-50 ( (Feb) ) 1920.
Freeman, L.W., et al:  Studies With Arteriovenous Fistulas: Influence of Posture Upon Volume Flow , Surgery 31:180-185 ( (Feb) ) 1952.
Leslie, M.B.; Portin, B.A.; and Schenk, W.G., Jr.:  Cardiac Output and Posture Studies in Chronic Experimental Arteriovenous Fistula , Arch Surg 81:123-128 ( (July) ) 1960.Article
Sumner, R.G., et al:  Recognition and Surgical Repair of Superior Mesenteric Arteriovenous Fistula , Circulation 27:943-950 ( (May) ) 1963.Article
Stone, H.H., et al:  Portal Arteriovenous Fistulas: Review and Case Report , Amer J Surg 109:191-196 ( (Feb) ) 1965.
Grafe, W.R., and Steinberg, I.:  Superior Mesenteric Arteriovenous Fistula Following Small Bowel Resection , Gastroenterology 51:231-235 ( (Aug) ) 1966.
Creech, O., Jr.; Gantt, J.; and Wren, H.:  Traumatic Arteriovenous Fistula at Unusual Sites , Ann Surg 161:908-920 ( (June) ) 1965.Article
Haberich, F.J.:  Osmoreception in the Portal Circulation , Fed Proc 27:1137-1141 ( (Sept) -Oct) 1968.