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.

Maher ER, Young G, Smyth-Walsh B, et al: Aortic and mitral valve calcification in patients with end-stage renal disease. Lancet 1987;ii:875–877.
Dumesnil JG, Pibarot P, Akins C: New approaches to quantifying aortic stenosis severity. Curr Cardiol Rep 2008;10:91–97.
Bos WJ, Zietse R, Wesseling KH, et al: Effects of arteriovenous fistulas on cardiac oxygen supply and demand. Kidney Int 1999;55:2049–2053.
Blais C, Burwash IG, Mundigler G, et al: Projected valve area at normal flow rate improves the assessment of stenosis severity in patients with low-flow, low-gradient aortic stenosis: the multicenter TOPAS (Truly or Pseudo-Severe Aortic Stenosis) study. Circulation 2006;113:711–721.
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