I need a detial step-by-step desrcbiton of a AV fistula procedure?

Answer 1

Compliments of http://www.bidmc.harvard.edu/display.asp?leaf_id=4401

What is an AV fistula?
The best way to establish long-term hemodialysis access is to construct an arteriovenous (AV) fistula. An AV fistula is a surgically placed "shunt" whereby an artery is directly sutured to a vein. An artery is a high-pressure tube that carries blood away from the heart and delivers nutrients and oxygen to the tissues. A vein is a low-pressure system that returns blood back to the heart to begin the process all over again.

When an artery and a vein are sewn together, the high-pressure blood does not reach the tissues but is diverted instead into the vein and back to the heart. Over time the vein will dilate, which is often called maturation. At maturation, nurses can easily access the vein with needles for dialysis therapy.

Where are AV fistulas located and how long do they last?
Surgeons can create an AV fistula in the wrist, forearm, inner elbow or upper arm. When properly constructed, and with satisfactory maturation, an AV fistula can function for many years.

How is the AV fistula procedure performed?
A surgeon usually performs the procedure in the operating room. The patient receives a local anesthetic (numbing medicine) at the proposed site along with sedation. Discomfort is minimal and the patient may even fall asleep during the procedure, which can take from one to two hours. The surgical incision is usually only two to four inches long. Generally patients are able to return home later that same day. The fistula usually requires from eight to 12 weeks for the veins to dilate prior to initial use.

Now from my own mouth....

My grandfather had a fistula for several years and was on Dialysis almost 6 years before he passed. For the most part his fistula functioned perfectly but there can be complications. The website mentioned above mentions some other complications, I would suggest reading it more thoroughly. The most common problem my grandfather had was the fistula becoming clogged with scar tissue. Your doctor may prescribe blood thinners to minimalize scar tissue and clotting. Another thing to be careful of is, if you are doing dialysis, do not remove your bandages too soon after your treatment. You can dislodge the clots at the needle sites and you may start bleeding again. So be sure your sites are securly clotted/scabbed before picking or removing bandages. Also always make sure you have a first aid kid handy with lots of gauze and bandages so if you do have a problem once you get home you have plenty of bandages, etc. to apply pressure and stop the bleeding. Another handy tip is to purchase a stethoscope. They are very inexpensive and it will give you peace of mind that your fistula is functioning. Usually you can feel the "thrill" by touching on top of the fistula but a stethoscope will allow you to hear it as well.

Hope this helps! And don't be scared!! This is a procedure that can not only save your life, but prevent added pain and discomfort if you do have to have dialysis.

Answer 2

Av Fistula Surgery Procedure Steps

Answer 3

Creating the access portal is a minor surgical procedure. There are two types of portals:

• Fistula, which your vascular surgeon constructs by joining an artery to a vein
• Graft, which is a man-made tube that your vascular surgeon inserts to connect an artery to a vein

For both fistulas and grafts, the connection between your artery and vein increases blood flow through the vein. In response, your vein stretches and becomes strengthened. This allows an even greater amount of blood to pass through the vein and allows your dialysis to proceed efficiently.

In the weeks after surgery, the fistula begins to mature. The vein increases in size and may look like a cord under your skin. The whole process typically takes 3 to 6 months. Some fistulas take as long as a year or more to develop fully, but this is unusual. Once matured, a fistula should be large and strong enough for dialysis technicians and nurses to insert the large dialysis needles easily. If it fails to mature in a reasonable period of time, you may need another fistula.

You can usually begin using your graft in 2 to 6 weeks, when it is healed sufficiently. Usually fistulas are preferred to grafts because fistulas are constructed using your own tissue, which is more durable and resistant to infection than are grafts. However, if your vein is blocked or too small to use, the graft provides a good alternative

Answer 4

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