Running on the Empty: hemodialysis patients with fluid overload, low blood pressure, and intractable congestive heart failure

The authors presented a case of congestive heart failure in a patient with end-stage renal disease on hemodialysis. The patient has low blood pressure and fluid overload making removal of the fluid by hemodialysis challenging task. The authors put a theory forward for discrepancies in the pressure between the two sides of the heart and propose a surgical procedure “septetomy of the inter-atrial septum” that might resolve the issue of hypotension on dialysis patients with fluid overload.