Renal effects of acute infrarenal aortocaval fistula

Abstract

Aortocaval fistula is an uncommon complication of abdominal aortic aneurysm rupture or penetrating abdominal trauma. Hemodynamic consequences of these large arteriovenous fistulas include increases in cardiac output and heart rate, with decreases in peripheral resistance and mean systemic arterial pressure. Physiologic sequelae of aortocaval fistulas have been investigated in experimental [9, 12, 21, 22, 24] as well as clinical [17, 20] settings. Altered renal function is a poorly understood but common consequence of aortocaval fistula [16, 18, 25, 27]. Acute changes in renal function are transient, resolving promptly with fistula closure [16, 24]. Although alluded to in previous works [15, 21], this phenomenon has not been subjected to extensive experimental study. The present investigation was designed to document carefully hemodynamic and renal effects of aortocaval fistulas in a canine model.