Research Article| Volume 52, ISSUE 3, P463-467, September 1962

Arteriovenous fistula and bacterial endocarditis

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      The intravenous injection of Strep, salivarius into rats with arteriovenous fistulas has resulted in the production of endocarditis, in 30 per cent of animals after 5 days. Three types of endocardial alteration similar to those observed in the human were found: (a) those simulating rheumatic endocarditis (b) those with the features of acute bacterial endocarditis, and (c) those of the combined “rheumatic-like” lesions of the valve and foci of suppurative necrosis containing bacterial masses.
      Of great interest was the observation that animals with fistulas failed to clear bacteria from their blood as readily as control animals. It is suggested that while cardiovascular stress initiated by the fistula may be, as proposed by others, highly significant in the production of such lesions, the persistence of small numbers of bacteria in the blood stream may in part account for the apparent increased “susceptibility” of cardiac endothelium to the development of such lesions in the presence of arteriovenous communications.
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        • Lillehei C.W.
        • Bobb J.R.R.
        • Visscher M.B.
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