Arteriovenous (AV) fistula surgery creates a channel for dialysis accessibility to the body’s circulatory system. An AV fistula is a tube that connects the body to a dialysis machine so that blood can be filtered and returned. AV fistula surgery entails stitching an artery and vein together, typically in the wrists or elbow area. This makes a stronger vein that can withstand many needle punctures for dialysis. After the AV fistula heals, one can see and feel the swollen vein.
How is AV Fistula Surgery performed: Before, During and After.
- AV fistula surgery is done after preoperative tests like blood tests, renal tests, chest X-rays, EKGs,etc. Quit smoking immediately before surgery.
- Follow the instructions for dialysis and medication usage properly.
- No eating and drinking before surgery.
- In the operating room, a surgeon often performs the surgery.
- A local anaesthetic is administered at the suggested location. There is little discomfort, and the patient may fall asleep during the one to two-hour treatment.
- Typically, the surgical incision is only 2 to 4 inches wide.
- Generally, the patient can return home the same day. Before using a fistula, the veins must dilate for 8-12 weeks.
Despite excellent therapy, some individuals may experience AV fistula complications like postoperative infection, bleeding, arm swelling, and finger tingling, etc.
Cost of the fistula surgery
| Description | Cost |
|---|---|
|
The average cost of the surgery |
approximately Rs.65,000 |
| Description | Cost |
|---|---|
|
Number of days in the hospital |
1 |
|
Type of surgery |
Minor |
|
Anaesthesia type |
General |
|
Recovery |
10-14 Days |
|
Duration of the procedure |
3-4 hours |
|
Surgery |
Minimal Procedure |
Risks and complications of the AV Fistula Surgery
The following are the general risk factors associated with surgery:
- An allergic inflammation and breathing problems
- Bleeding can result in shock or necessitate the use of blood transfusions
- Deep vein thrombosis, in particular, can cause blood clots.
- Infection
The following are possible complications after AV fistula surgery:
- AV fistula blood clot that occurs and prevents blood flow
- Fistula failure
- The skin and tissues surrounding the Fistula can get infected.
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Frequently Asked Questions about AV Fistula
AV fistulas are frequently created surgically to facilitate dialysis in patients with severe renal disease. Untreated AV fistulas of significant size might result in serious complications. An AV fistula can be treated more easily if detected early. Additionally, it may help in avoiding formation of blood clots or heart problems.
The method of creating an AV fistula surgery for dialysis access is considered to be low-risk. It is frequently time-sensitive due to the importance of avoiding central venous catheters (CVCs) with their consequences.
These are dural AV fistulas associated with higher venous pressure or vein constriction on the brain’s covering. Increased pressure on veins can cause them to rupture, resulting in intracerebral haemorrhage.
The wound has to be covered for seven days and might take 10 to 14 days to heal completely. The dressing is changed once every three days.
For the next two weeks,performing any hard lifting or applying pressure on the fistula arm must be avoided. Bending the fistula arm for extended periods should be avoided. Dissolvable sutures are the norm for most people. Clips may need to be removed.
After AV fistula surgery, the patient is advised not to wet the dressing for the first two days. The patient can take a bath or shower normally after the dressing is removed. In the case of CVC, it is critical to maintain a dry dressing at all times. The dressing should be covered with plastic while showering. Taking a bath, swimming or relaxing in a hot tub should be avoided.
- Before and after surgery, wash hands thoroughly with soap and water to avoid touching the AV fistula.
- Keep the skin surrounding the fistula hygienic by washing it frequently with antibacterial soap, particularly before dialysis. Wash and gently pat dry the fistula.
- Strengthen the arm when the wound has healed, as suggested by the doctor.
- Only use it for dialysis.
- See if the fistula region is red or swollen.
- Protect and avoid any harm to the arm.
- Ensure a sufficient diet for optimal health.
Over the next few days, the patient should expect to feel some discomfort and swelling in the area. Keep the arm supported on pillows whenever feasible for the first few days following the access surgery. Keep the arm elevated above the heart level to minimise swelling and discomfort.
Exercise stimulates the flow of blood to the arm. As a result, a needle may be inserted more easily since the fistula has grown stronger. Strengthening the muscles surrounding the fistula provides support to the fistula.
For two weeks, avoid strenuous physical activity. Stop taking prescribed pain medication before driving. As long as the patient doesn’t lift anything heavy, he can resume his normal daily routine.
The pus or blood that drains from the fistula may be noticeable in some cases. This is very common in the days following surgery. For 1–2 days following the surgery, a patient may experience spotting or bleeding. If necessary, place a gauze pad over the fistula opening to absorb the drainage. One to two weeks after surgery, most patients can return to their daily routines and go back to work.
Unfortunately, infection or Fistula might recur even after thorough treatment and healing. If an abscess recurs, it may indicate the presence of a fistula that requires treatment. If the Fistula recurs, more surgery will certainly resolve the issue.
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