Effect of a surgical aortocaval fistula on monocrotaline-induced pulmonary hypertension

Crit Care Med. 2003 Apr;31(4):1213-8. doi: 10.1097/01.CCM.0000059440.44597.07.


Objective: Increased pulmonary blood flow is believed to contribute to the development of pulmonary hypertension. We investigated the effect of overcirculation via an aortocaval fistula, on the development of monocrotaline-induced pulmonary hypertension in rats. Monocrotaline was administered 1 wk after the creation of an aortocaval fistula.

Design: Randomized, controlled study.

Setting: Research laboratory of an academic institution.

Subjects: Male Sprague-Dawley rats.

Interventions: Overcirculation was induced by pneumonectomy and by surgical creation of aortocaval fistula. Pulmonary artery hypertension was induced by administration of monocrotaline.

Measurements and main results: Aortic blood flow, Pao(2), and pulmonary arterial pressure were measured 4 wks later. A blinded investigator quantified pulmonary arterial neointimal formation in small pulmonary arteries. Compared with animals that received monocrotaline and/or underwent pneumonectomy but did not undergo aortocaval fistula, the presence of a surgical aortocaval fistula was associated with increased aortic blood flow (p <.001), increased Pao(2) (p <.001), and lower mean pulmonary arterial pressure (p <.001). In addition, rats with aortocaval fistula had less pulmonary arterial neointimal formation than matched animals without an aortocaval fistula (p =.034).

Conclusions: The presence of a surgical aortocaval fistula attenuates, rather than worsens, the development of monocrotaline-induced pulmonary hypertension in rats.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Abdominal / surgery*
  • Arteriovenous Shunt, Surgical*
  • Blood Flow Velocity
  • Blood Pressure
  • Cardiac Output
  • Hypertension, Pulmonary / chemically induced
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / pathology
  • Hypertension, Pulmonary / physiopathology*
  • Hypertrophy, Right Ventricular / etiology
  • Lung / blood supply*
  • Male
  • Monocrotaline
  • Pneumonectomy
  • Pulmonary Artery / pathology
  • Rats
  • Rats, Sprague-Dawley
  • Tunica Intima / pathology
  • Ultrasonography, Doppler
  • Vena Cava, Inferior / surgery*


  • Monocrotaline