An AV fistula is a connection made between an artery and a vein by surgery. This surgical connection is done by a board-certified surgeon. An AV fistula is regularly situated in your arm, in any case, in the event that essential it tends to be set in the leg. With an AV fistula, blood streams from the artery into the vein increase the blood pressure and measurement of blood flowing through the vein. The increase in blood pressure is responsible for vein enlargement. The enlarged veins will be equipped for conveying how much bloodstream is important to give a sufficient hemodialysis treatment. AV fistulas are the favored vascular access for long-haul dialysis since they last longer than some other dialysis access types, are less inclined to disease and coagulating, and can be depended upon for unsurprising execution.
Preparation for AV Fistula Surgery
While preparing for an AV fistula creation, a Doppler ultrasound will be done to map the blood vessels to check the speed of blood movement through the different blood vessels, this procedure lets the surgeon pick the most proper blood vessel for the fistula.
During the discussion with your surgeon, you must inform them about your medical history, allergies, and any medications like blood thinners as blood thinners can slow the healing process.
You might be approached to try not to eat and drink after midnight on the day preceding the AV fistula surgery.
The Procedure of AV Fistula Surgery
Firstly, your surgeon will clean the skin over the AV fistula site with a sterile arrangement and then he will give you local anesthesia to numb you, so you won’t feel any pain during the surgery. Sometimes general anesthesia is given to the patient before the surgery, it completely depends on the patient’s situation.
Then, a little incision will be made to get to the blood vessels. The chosen artery and vein will be incised and connected surgically with sutures and over it, the bandages will be placed.
Recovery After AV Fistula Surgery
AV fistula creation can be acted in a short-term setting and most patients can hope to be released following a couple of hours in the recuperation room. There might be a discharge after the surgery and the patient might feel little soreness for a couple of days. You will be given medicine for any postoperative aggravation and encouraged to keep the arm raised to lessen enlarging. Explicit guidelines will be given on the most proficient method to really focus on the AV fistula access site. It takes around 2 to 90 days before the fistula is created and mature to the point of being utilized for hemodialysis.
AV fistula creation can be performed in an outpatient setting and most patients can expect to be discharged after a few hours of the surgery. There might be a slight discharge for a day and soreness from the incision area for a few days after surgery. You will be given medicines for any postoperative pain and your surgeon will advise you to keep the arm elevated to reduce swelling. Specific instructions will be given on how to care for the AV fistula access site. It takes about 2 to 3 months before the fistula is developed and mature enough to be used for hemodialysis.
To safeguard the treated area, you ought to do the following activities
- Wash the vascular access site consistently and keep it clean and dry.
- Make sure that your surgeon checks the entrance site before every hemodialysis treatment.
- Use the entrance site just for dialysis.
- Be cautious not to knock or harm the entrance site.
- Avoid putting a blood pressure cuff, tight clothes, or any kind of jewelry over the treated area.
- Avoid lifting heavy objects with the treated arm.
- Do not sleep with the treated arm under your head or body.
- Report any indications of redness, swelling, or pus drainage to your surgeon as soon as you can.
Complications and risks of AV Fistula Surgery
- Infection – Infection is one of the common risks of an AV fistula surgery. Most infections cause redness and inflammation at the vascular access site and can be treated easily with medications. While some major infections need surgical intervention and drainage.
- Thrombosis due to blood clots – The AV fistula surgery causes the formation of blood clots that leads to deep vein thrombosis which includes severe pain, tremors, and loss of sensation. The risk of blood clots may lead to stroke sometime.
- Stenosis – Stenosis can obstruct outflow from the veins.
- Congestive heart failure – Sometimes patients feel shortness of breath and increased intensity of the pumping may weaken the heart muscle and that causes heart failure.
- Pain
- Sensory loss
- Weakness of hand and fingers or leg depending on the placement of AV fistula.
- Paresthesia
- Aneurysm
- Internal bleeding
In case of severe pain, continuous bleeding, or any other major side effects, contact your surgeon immediately. However, you can reduce the chance of major complications by choosing a board-certified surgeon.
Cost of AV Fistula Surgery
The cost of AV fistula surgery in India may vary between Rs. 30,000 to Rs. 65,000 and the price variation depends on multiple factors like: –
- Location of the clinic
- Surgeon’s skills and experience
- Anesthesia cost
- Medications
- And other factors
- Location of the fistula
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