Arteriovenous Fistula Creation For Hemodialysis

WHAT YOU SHOULD KNOW:

An arteriovenous fistula (AVF) is a surgical connection of an artery to a vein. This is a common procedure for hemodialysis. The fistula is usually done on the nondominant arm. For example, if you are right-handed, the AVF will be created on your left arm. Blood will go out from and come back to the AVF after it is cleaned by the hemodialysis machine.

CARE AGREEMENT:

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

RISKS:

You may bleed more than expected or get an infection. You could have trouble breathing or get blood clots. You may have continued pain or swelling after the surgery. The surgery may not be successful and may need to be done again. If you do not have surgery, your symptoms may get worse.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Anesthesia is medicine that makes you comfortable during the surgery. Caregivers will work with you to decide which anesthesia is best for you.

During your surgery:

An incision will be made on your skin between the blood vessels. Tools will be used to separate the vein and the artery from nearby tissues. Once the 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. After the vessels are joined together, the other ends of the artery and vein will be 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 your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be taken to your hospital room.

  • You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • Medicines:

    • Antibiotics help treat or prevent an infection caused by bacteria.

    • Antinausea medicine calms your stomach and helps prevent vomiting.

    • Prescription pain medicine may be given to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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