ISSN 2398-2969      

Heart: peripheral arteriovenous fistula

icanis
Contributor(s):

Chris Little

Mark Oyama

Synonym(s): AV fistula (single, AV fistulae (multiple, Acquired shunt(s


Introduction

  • AV fistulae are acquired vascular malformations that allow blood flow to bypass the capillary bed, and as such allow arterial blood to directly enter the venous system.
  • Consequences of AV fistula involve decreased arterial perfusion to the bypassed tissues, increased venous return to the heart, and decreased peripheral vascular resistance.
  • Chronically, decreased vascular resistance can lead to fluid retention and high-output heart failure.
  • AV fistulae must be discriminated from extracardiac arteriovenous shunts due to single or multiple congenital defects of the vasculature.

Pathogenesis

Etiology

  • Most AV fistulas are the result of previous trauma.

Pathophysiology

  • AV fistulas allow arterial blood flow to bypass the capillary bed and to directly enter the venous system. By doing so, peripheral vascular resistance in this portion of the vasculature is greatly reduced and cardiac output increases secondary to reduced afterload and retention of fluid. Preload to the heart is increased and congestive heart failure Heart: congestive heart failure can result (high-output heart failure). Collateral circulation to the affected extremity helps maintain perfusion, however, the affected extremity is often ischemic, edematous, and painful.

Timecourse

  • Most AV fistulas are the result of previous trauma to the area (iatrogenic, blunt trauma, infection, etc.). AV fistulae can also occur in association with neoplasms.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Trower N D et al (1997) Arteriovenous fistula involving the prepuce of a dog. JSAP 38 (10), 455-458 PubMed.
  • Bouayard H et al (1987) Peripheral acquired arteriovenous fistulas: a report of four cases and literature review. J Am Anim Hosp Assoc 23, 205 VetMedResource.
  • Butterfield A B et al (1980) Acquired peripheral arteriovenous fistula in a dog. JAVMA 176, 445-448 PubMed.

Other sources of information

  • Kittleson M D & Kienle R D (1998)The effects of Systemic Disease on the Cardiovascular System.In:Small Animal Cardiovascular Medicine. Mosby, p552.
  • Oliver N B (1985)Pathophysiology of arteriovenous fistulae.In: Slatter DH (ed)Textbook of Small Animal Surgery. Philadelphia, WB Saunders, 1985, p 923.

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