Development of Hyperacute High-Output Heart Failure at the Time of Dialysis Access Creation

Abstract Introduction High-output heart failure can occur in patients undergoing hemodialysis via permanent access. We describe two instances of hyperacute high-output heart failure. Case Report Two patients with multiple prior failed access attempts presented for redo access. Each patient experienced high-output heart failure in the operating room at the time of access placement. A delay in diagnosis led to the first patient's death, while early recognition led to successful management of the second patient. Conclusion Hyperacute heart failure at the time of access creation is uncommon. Early recognition of this complication is important as timely intervention can be life-saving.