Impact and Management under Extracorporeal Circulation of a Patient with Renal Insufficiency on Dialysis with a High-Flow Arteriovenous Fistula in the Cardiac Surgery Department of the Angers Teaching Hospital about a Case and Review of the Literature  

作　　者：Abdoulaye Kanté Bréhima Coulibaly Mamadou Diakité Mamadou A. Keita Bakary Keita Drissa Traoré Nouhoum Ongoïba Patrice Binuani Christophe Baufreton Abdoulaye Kanté;Bréhima Coulibaly;Mamadou Diakité;Mamadou A. Keita;Bakary Keita;Drissa Traoré;Nouhoum Ongoïba;Patrice Binuani;Christophe Baufreton(Department of Thoracic and CardiovascularSurgery, CHU Point G, Bamako, Mali;Cardiac Surgery Department of the University Hospital of Angers, Angers, France;Cardiology Department, CHU Point G, Bamako, Mali;Commune II Reference Health Center, Bamako, Mali)

机构地区：[1]Department of Thoracic and CardiovascularSurgery, CHU Point G, Bamako, Mali [2]Cardiac Surgery Department of the University Hospital of Angers, Angers, France [3]Cardiology Department, CHU Point G, Bamako, Mali [4]Commune II Reference Health Center, Bamako, Mali

出　　处：《Open Journal of Thoracic Surgery》2023年第1期1-5,共5页胸外科期刊（英文）

摘　　要：Arteriovenous fistulas have a substantial impact on systemic hemodynamics, however their effect on extracorporeal circulation is not well understood. We report our clinical observation on the management under extracorporeal circulation of a patient with renal insufficiency with a high-flow arteriovenous fistula. This is a 59-year-old man who was referred to us for surgical treatment of ischemic coronary artery disease in a context of anuric chronic renal failure. Hypothermia at 32°C is started from the start in CEC due to hyperflow at the level of the arteriovenous fistula. We performed two coronary artery bypasses of the marginal and IVA via the two internal thoracic arteries. The patient is hemofiltered in order to avoid hyperkalaemia and possibly avoid fluid overload related to filling per CEC. The clamping time was 71 minutes and the SCC lasted 141 minutes. There was no homologous transfusion in the operating room. It turns out that the input/output balance is zero at the end of the CEC. The postoperative course was simple.Arteriovenous fistulas have a substantial impact on systemic hemodynamics, however their effect on extracorporeal circulation is not well understood. We report our clinical observation on the management under extracorporeal circulation of a patient with renal insufficiency with a high-flow arteriovenous fistula. This is a 59-year-old man who was referred to us for surgical treatment of ischemic coronary artery disease in a context of anuric chronic renal failure. Hypothermia at 32°C is started from the start in CEC due to hyperflow at the level of the arteriovenous fistula. We performed two coronary artery bypasses of the marginal and IVA via the two internal thoracic arteries. The patient is hemofiltered in order to avoid hyperkalaemia and possibly avoid fluid overload related to filling per CEC. The clamping time was 71 minutes and the SCC lasted 141 minutes. There was no homologous transfusion in the operating room. It turns out that the input/output balance is zero at the end of the CEC. The postoperative course was simple.

关 键 词：Coronaryartery by Pass Grafting High Flow Arteriovenous Fistula Extracorporeal Circulation HYPOTHERMIA 

分 类 号：R54[医药卫生—心血管疾病]