%0 Journal Article
%T 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
%A Abdoulaye Kant¨¦
%A Br¨¦hima Coulibaly
%A Mamadou Diakit¨¦
%A Mamadou A. Keita
%A Bakary Keita
%A Drissa Traor¨¦
%A Nouhoum Ongo£¿ba
%A Patrice Binuani
%A Christophe Baufreton
%J Open Journal of Thoracic Surgery
%P 1-5
%@ 2164-3067
%D 2023
%I Scientific Research Publishing
%R 10.4236/ojts.2023.131001
%X 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¡ãC
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.
%K Coronaryartery by Pass Grafting
%K High Flow Arteriovenous Fistula
%K Extracorporeal Circulation
%K Hypothermia
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=123511