The coexistence of aortic valve stenosis (AS) with hemodialysis arteriovenous (AV) fistula complicates the assessment of the severity of valvular disease. We describe the physiological changes in stenotic indices which occur following manual compression of the AV fistula. The manual compression of the AV fistula is capable of inducing significant alterations in transvalvular flow rates and valvulo-arterial impedance that translates into important changes in aortic valve hemodynamics and grading of stenosis severity.

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