Abstract: FR-PO1043
Health-Related Quality of Life After Ligation of Arteriovenous Fistula for Pulmonary Hypertension
Session Information
- Hypertension and CVD: Clinical Outcomes, Trials
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1402 Hypertension and CVD: Clinical, Outcomes, and Trials
Authors
- Rohan, Vinayak, Medical University of South Carolina, Charleston, South Carolina, United States
- Dennis, Patrick B., Medical University of South Carolina, Charleston, South Carolina, United States
- Flower, Katie M., Medical University of South Carolina, Charleston, South Carolina, United States
- Soliman, Karim Magdy Mohamed, Medical University of South Carolina, Charleston, South Carolina, United States
- Baliga, Prabhakar, Medical University of South Carolina, Charleston, South Carolina, United States
- Taber, David J., Medical University of South Carolina, Charleston, South Carolina, United States
Background
AV fistulas (AVF) are the access method of choice in patients on long-term hemodialysis. Due to their high blood flow, AVFs are also a potentially reversible cause of secondary pulmonary hypertension. There are multiple small case series describing change in the hemodynamics and improvement in the symptoms after ligation of AVF for pulmonary hypertension. There is very little data regarding health related quality of life changes (HRQOL) after ligation AV fistula for Pulmonary HTN
Methods
Patients undergoing ligation of AVF for Pulmonary Hypertension (PHT) were identified from our AVF database from January 2017 to December2018. All patients were specifically referred from the PHT clinic with the diagnosis of moderate or severe PHT. Detailed demographics, postoperative clinical variables and recipient’s outcomes were abstracted from electronic health records. We used emPHasis10, a validated PHT HRQOL questionnaire developed by the Pulmonary Hypertension Association, United Kingdom and freely available over for use. Patients were asked to respond to the questionnaire before and after ligating the fistula. Statistical comparisons were made using the Wilcoxon signed-rank test.
Results
We identified 9 patients who underwent ligation of AV fistula for PHT. One patient died during the follow up period and one patient was lost to follow up hence 7 patients were included in the study. The mean age was 47.7 years (range 33-58), 5 patients were male and 2 females. All the patients presented with an upper arm arteriovenous fistula. The mean pre-ligation emPH asis-10 score was 29.0±15.1 and post-ligation this significantly decreased to 6.1±5.2(p<0.01), indicating significant improvements in HRQOL surrounding PHT
Conclusion
Ligation of AV fistula for secondary pulmonary HTN may potentially lead to significant improvement in pulmonary hypertension indices and health-related quality of life
| Patient Number | Age | Sex | Race | Pre-Procedure emphasis 10 score | Post- Procedure emphasis 10 Score | Duration of follow Up in months |
| 1 | 51 | M | AA | 18 | 4 | 21 |
| 2 | 39 | M | AA | 45 | 15 | 19 |
| 3 | 42 | F | AA | 24 | 1 | 16 |
| 4 | 58 | M | AA | 35 | 12 | 10 |
| 5 | 33 | M | W | 28 | 4 | 8 |
| 6 | 56 | M | AA | 48 | 4 | 7 |
| 7 | 55 | F | AA | 5 | 3 | 14 |