Avoiding Venous Anastomotic Dehiscence of an Arteriovenous Graft in a Super-Obese Patient
Surgeons avoid creating arteriovenous fistulae in obese patients owing to deep vessels, cannulation complications, and inconsistent outcomes. We describe placing an arteriovenous polytetrafluoroethylene (PTFE) graft between the brachial artery and axillary vein to avoid these complications. A 39-...
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| Format: | Article |
| Language: | English |
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Korean Society for Thoracic and Cardiovascular Surgery
2020-12-01
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| Series: | Korean Journal of Thoracic and Cardiovascular Surgery |
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| Summary: | Surgeons avoid creating arteriovenous fistulae in obese patients owing to deep vessels,
cannulation complications, and inconsistent outcomes. We describe placing an arteriovenous
polytetrafluoroethylene (PTFE) graft between the brachial artery and axillary vein
to avoid these complications. A 39-year-old super-obese woman with end-stage renal
disease had undergone several hemodialysis access procedures on both arms. We traced
the course of the arteriovenous graft course with the patient sitting and lying down. The
ideal course was more accurate with the patient sitting; thus, the patient sat when the
course was drawn, before lying on the operating bed. The PTFE graft was placed between
the right brachial artery and axillary vein, according to the course in the opposite arm. No
anastomotic dehiscence or pseudoaneurysm has taken place during 2 years of follow-up.
In super-obese patients, the ideal course for arteriovenous grafts should be drawn while
they are sitting, avoiding skin folds. This tip could avoid anastomotic dehiscence and pseudoaneurysm between the axillary vein and a PTFE graft. |
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| ISSN: | 2233-601X 2093-6516 |