Experimental Pulmonary Arteriovenous Fistula

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Abstract
A technic for establishing pulmonary arteriovenous fistulas in dogs by limited pulmonary resection and end-to-end anastomosis of the artery and major vein supplying the removed lobes is described. In acute expts. it was found that the mean pulmonary arterial pressure decreased, the mean carotid arterial pressure increased and arterial O2 saturation decreased when such a fistula was opened. When, in addition, the opposite pulmonary artery was constricted, these changes were even more marked in degree. In 3 animals in which it was determined, O2 capacity after opening the fistula was greater than before. In survival studies, 4 of 16 animals in which the procedure was carried out survived for weeks or months with arterial O2 saturation ranging from 66 to 90%. Attempts to increase the flow through the shunt by constricting the pulmonary artery of the opposite lung were unsuccessful. In 2 animals with patent fistulas, chronic hypoxemia with secondary polycythemia, hypervolemia, and increased hematocrit readings resulted. An inverse relationship between arterial oxygen saturation and oxygen capacity was found in these 2 animals for periods up to 65 weeks. The avg. cardiac output of the hypoxemic dogs fell in the same range as that of 2 groups of control animals.
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