an arte rio venous fistula

8/3/2019 An Arte Rio Venous Fistula

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An arteriovenous fistula (AV fistula) is the connection of a vein and an artery, usually in theforearm, to allow access to the vascular system for hemodialysis, a procedure that performs the

functions of the kidneys in people whose kidneys have failed. Connecting the vein and artery is asurgical procedure. The fistula develops over a period of months after the surgery.

Purpose

The surgical creation of an AV fistula provides a long-lasting site through which blood can beremoved and returned during hemodialysis. The fistula, which allows the person to be connected

to a dialysis machine, must be prepared by a surgeon weeks or months before dialysis is started.When the vein and artery are joined, the vein gradually becomes larger and stronger, creating the

fistula that provides vascular access years longer than other types of access and with fewer complications.

Sometimes dialysis is only needed temporarily, but some people need it for the rest of their livesor until a kidney is available for a transplant. When kidney failure is diagnosed, time is needed to prepare the patient's body with either an AV fistula or implantable devices that will connect the

person to the dialysis machine.

Read more: Arteriovenous Fistula - procedure, blood, tube, removal, complications, time,infection, graft, heart, types, cancer, nausea, Definition, Purpose, Demographics, Description,

Diagnosis/Preparation http://www.surgeryencyclopedia.com/A-Ce/Arteriovenous-Fistula.html#ixzz1j9D2rMhj

Arteriovenous Fistula Creation For Hemodialysis

What you should know

Arteriovenous Fistula Creation For Hemodialysis (Precare) Care Guide

y Arteriovenous Fistula Creation For Hemodialysis Aftercare Instructions

y Arteriovenous Fistula Creation For Hemodialysis Discharge Care

y Arteriovenous Fistula Creation For Hemodialysis Inpatient Care y Arteriovenous Fistula Creation For Hemodialysis Precare

y En Espanol

y An arteriovenous (ahr-te-re-o-VE-nus) fistula (FIS-tu-lah), also called AVF, is a surgical

connection of an artery directly to a vein. This is usually done in those needing hemodialysis.

Hemodialysis is a treatment for acute (sudden) and chronic (long term) kidney failure. It uses a

machine that works like the real kidneys to clean waste from your blood. The AVF will act as the



bridge for blood to go into the hemodialysis machine. The fistula is usually done on the arm that

is not always used (left arm if you are right handed and vice versa). It is where your caregiver

puts needles during hemodialysis. Blood will go out from and come back to the AVF after being

cleaned by the hemodialysis machine.

y y Healthy kidneys clean the blood by removing harmful substances like excess fluid, minerals, and

toxic (harmful) wastes. They also make substances that help keep your bones strong and your

blood healthy. Kidney failure causes harmful wastes to build up in your body, leading to a rise in

your blood pressure. It may also cause your body to retain excess fluid and not make enough redblood cells. When this happens, you may need treatment to replace the work of your failing

kidney. Having an AVF for hemodialysis may relieve your symptoms of kidney failure, and

improve quality of life.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may betreated. Discuss treatment options with your caregivers to decide what care you want to receive.

You always have the right to refuse treatment.

Risks

Surgery to make an arteriovenous fistula carries certain risks. You may bleed more than expected

or get an infection. You could have trouble breathing or get blood clots. You could have anallergic reaction to an anesthesia medicine. Your caregivers will watch you closely for these

problems. You may have continued pain or swelling after the surgery. Sometimes the surgerymay not be successful and need to be done again. If you do not have surgery, the pain or



symptoms you have may get worse. Call or ask your caregiver if you are worried or have morequestions about your surgery.

Getting R eady

The week before your surgery:

y Ask a family member or friend to drive you home after your surgery. Do not drive yourself

home.

y Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter

medicine before your procedure or surgery.

y If you have diabetes, ask your caregiver for special instructions about what you may eat and

drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special

instructions about using it before surgery. You may need to check your blood sugar more often

before and after having surgery.

y Tell your caregiver if you have had previous catheters, procedures, or surgery done on your

arms. Your caregiver may also ask you more about your previous diseases or medicines that you

are taking.

y If you are a female, tell your caregiver if you know or think that you are pregnant.

y You may need to have blood tests, electrocardiogram (ECG), chest x-ray, and other tests to

know how your kidneys are. Ask your caregiver for more information about these tests that you

may need. Ask your caregiver for more information about these and other tests that you may

need. Write down the date, time, and location of each test.

The night before your surgery:

y Remove any nail polish.

y You may be given medicine to help you sleep.

y Ask caregivers about directions for eating and drinking.

The day of your surgery:

y Write down the correct date, time, and location of your surgery.

y What to bring: You may want to bring items such as a toothbrush and bathrobe.

y Ask your caregiver before taking any medicine on the day of your surgery. These medicines

include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you

are taking, including the pill bottles, with you to the hospital.



y If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses

may be worn.

y Do not wear tight-fitting clothes on the day of your procedure or surgery.

y Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually

chosen. Through the IV tube, you may be given liquids and medicine.

y An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine

to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in

your family has had a problem using anesthesia in the past.

y You or a close family member will be asked to sign a legal document called a consent form. It

gives caregivers permission to do the procedure or surgery. It also explains the problems that

may happen, and your choices. Make sure all your questions are answered before you sign this

form.

Treatment

What will happen:

y You will be asked to change into a hospital gown. You will be given medicine to help you relax or

make you drowsy. You will be taken on a stretcher to the operating room. You may be given a

local, regional or general anesthesia to control pain during the surgery. You will be placed lying

on your back. The whole arm where the AVF will be done will be cleaned with a cleansing liquid.

Sheets will be put over you to keep the area clean.

y During your surgery, an incision (cut) will be made on the skin, midway between the blood

vessels. Special tools will be used to separate the vein and the artery from nearby tissues. Oncethe blood vessels are seen, your caregiver will decide on how to join them together. Incisions

will be made on both vessels and they will be attached with stitches (threads). After the vessels

are joined together, the other ends of the artery and vein are tied and cut. This is done to direct

the blood to enter into a single passageway. Once the fistula is created, the skin will be closed

with stitches.

After surgery:

You are taken to a room where your heart and breathing will be monitored. Do not get out of bed

until your caregiver says it is okay. A bandage may cover wounds to help prevent infection. You

may be able to go home after some time passes. If you had general anesthetic, an adult will needto drive you home. Your driver or someone else should stay with you for 24 hours. If you cannotgo home, you will be taken to a hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask

your visitors to provide a way to reach them if they leave the waiting area.



Contact a caregiver if

y You cannot make it to your appointment on time.

y You have a fever.

y You have a skin infection or an infected wound near the area where the surgery will be done.

y You have questions or concerns about your surgery.

Seek Care Immediately if

y The problems for which you are having surgery get worse.

How to Harvest a Saphenous Vein

By Lynn Yoffee, eHow Contributor

y y y y Print this article

The saphenous vein, which runs inside the leg from the ankle to the groin, can be harvested for use in coronary artery bypass graft surgery as a detour around arterial blockages. Removal of this

large vein will not adversely affect the leg, although swelling can occur. There are two ways toharvest the vein. Endoscopic harvesting is the most commonly used approach because it is

minimally invasive compared with traditional open harvesting, which requires a long incision.Endoscopic harvesting reduces postoperative pain and infection and shortens the hospital stay,

according to a Duke University Medical Center study comparing the two procedures.

Related Searches:

y Vein Legs

y Great Saphenous Vein

Difficulty:

Challenging

Instructions

1. Prepare the Veino 1



Administer general anesthesia. Harvesting a saphenous vein endoscopicallyusually takes about 2 to 3 hours in the operating room while you are asleep,

according to Sutter Heart & Vascular Institute.

o 2

Make a 2-cm incision at the groin. Identify the saphenous vein position. Dissect

the tissue surrounding the vein until the adventitia--the connective tissuesurrounding the artery--is exposed.

o 3

Make another incision, also about 2 cm long, in the knee area.

o 4

Insert an endoscope into the groin-area incision. A surgeon will use this thinscope, which has a small camera on the end, to look at the saphenous vein andhelp guide removal.

o 5

Inflate a balloon attached to the endoscope. As the surgeon moves the endoscope

alongside the vein, a tiny balloon is inflated and deflated every 2 cm. This helpscut the tissue around the vein and any side branches of the vein.

2. R emove the Veino 1

Continue to move the endoscope toward the knee. On reaching the knee, thecamera is removed and a dissector tool is introduced through one of the

previously made incisions to cut the vein from the tissue.

o 2

Remove the vein. The surgeon will pull the freed vein out through the incisionnear the knee.

o 3

Stitch the incisions and wrap the leg. Tight compression is needed to prevent

bleeding. The harvested saphenous vein is now ready for use, mostly commonlyin coronary artery bypass graft surgery but also for other types of bypass surgery.

o 4



Watch for signs of complications. If the sites of incision become infected you maynotice redness, pain, swelling, excessive bleeding or discharge, chills and fever,

color changes in your leg, numbness or a cold leg, shortness of breath, chest pain,cough, dizziness, or a swollen, red or warm calf.

Read more: How to Harvest a Saphenous Vein | eHow.com

http://www.ehow.com/how_5845723 _harvest-saphenous-vein.html#ixzz1 j9DrqyY3

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