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Arteriovenous Graft Placement For Hemodialysis

What you should know

An arteriovenous graft (AVG) is surgery to connect an artery to a vein using a graft. A graft is a plastic tube. You need an AVG if your artery and vein cannot be directly joined together for hemodialysis. The AVG is usually placed on the nondominant arm. For example, if you are right-handed, the AVG will be placed on your left arm. Blood will go out from and come back to the AVG 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. Without this surgery, your symptoms may get worse.

Getting Ready

The week before your surgery:

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

  • Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Tell your caregiver if you have had previous catheters, procedures, or surgery done on your arms. Your caregiver may also ask about your previous diseases, or any medicines that you are taking.

  • You may need to have blood tests, an electrocardiogram (ECG), a chest x-ray, and other tests. Ask your caregiver for more information about these tests. Write down the date, time, and location of each test.

The night before your surgery:

  • You may be given medicine to help you sleep.

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.

  • 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.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

  • 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:

You will be given anesthesia to control pain during the surgery. An incision will be made between the blood vessels. Tools will be used to separate the vein and the artery from nearby nerves and tissues. Clip-like tools will be placed on both blood vessels to stop the blood flow. Incisions will be made on the blood vessels where the graft (plastic tube) will be attached. One end of the graft will be inserted into the artery and the other into the vein. Stitches will be used to secure the graft to the blood vessels. The clip-like tools will be removed and the blood vessels checked for blood flow. The graft will be positioned close to the skin, and 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.

Contact a caregiver if

  • You cannot make it to your surgery on time.

  • You have a fever.

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

  • You have questions or concerns about your surgery.

Seek Care Immediately if

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

  • Your blood pressure is higher or lower than your caregiver has told you it should be.

© 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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