High-output congestive failure from femoral arteriovenous shunts for vascular access

Femoral arteriovenous bovine shunts (FAVBS) represent an accepted method of vascular access for patients requiring chronic hemodialysis. The authors present 4 patients who required corrective surgery for high-putput congestive heart failure (HOCHF) secondary to high flow rates through the shunt. In order to avoid this serious complication, intraoperative graft flow rates should not exceed 900 cc/min. HOCHF secondary to FAVBS may be refractory to conservative therapy and require either banding of the shunt or its removal.