Serial orthopedic and hemodynamic measurements made in a child before, during, and after the creation of a systemic arteriovenous fistula to promote growth of a shortened leg are reported. The mechanisms and associated clinical phenomena of the hemodynamic load imposed by the fistula are discussed. This procedure may be, to date, the most effective method for diminishing the disparity between the lengths of two limbs. In a child with a normal heart the creation of such a fistula may impose no cardiac hazard. However, in some children, especially those with cardiac disease, there may be serious cardiovascular consequences. This procedure requires at all stages the close collaboration of the orthopedic surgeon, the vascular surgeon, and the cardiologist.
Meyer AD, Muenster JJ, Olwin JH, Shapiro FS, Graettinger JS. Consequences of Creation of Arteriovenous Fistula: Orthopedic and Cardiovascular Effects in a Patient with a Shortened Leg. JAMA. 1963;184(8):611–615. doi:10.1001/jama.1963.03700210045007
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: