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Dialysis (AV Shunt)
What is
Dialysis (AV Shunt)?
Connection to the machine is made through a
temporary hook-up called an arteriovenous shunt
("AV shunt" for short). The shunt is made up of
two flexible plastic tubes, one attached to an
artery in your arm or leg, the other inserted in
a nearby vein. The tubes stick out of the skin,
permitting easy attachment to a dialysis
machine.
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Effects
of Dialysis (AV Shunt)
The
dialysis machine processes contaminated blood
from the body and returns it free of waste.
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Candidates for Dialysis (AV Shunt)
If
your kidneys need temporary assistance with
their job of filtering waste products from the
blood, your doctor may order short-term
treatment with a dialysis machine.
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Your Consultation
The
week before surgery:
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You'll probably need to stop taking aspirin
and ibuprofen; the doctor will tell you when.
If you're taking aspirin for your heart, don't
stop without asking the doctor first. Also ask
whether you can take any over-the-counter
medicines.
-
Your
doctor will tell you whether you need to have
blood drawn.
The
night before surgery:
-
Your
physician may suggest you take a sleeping
pill.
-
Just
before surgery, you should not eat or drink
anything (even water). Your doctor will tell
you when to begin fasting.
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The
Dialysis (AV Shunt) Procedure
An
arterio-venous shunt is surgically created which
consists of two pieces of silastic tubing, each
with a Teflon tip on one end. The Teflon tip of
one piece of the shunt tubing is placed in an
artery and the Teflon tip of the other is placed
in an adjacent vein. The tubing is then brought
through two puncture wounds in the skin and
connected. The AV shunt has limited life-span
due to clotting or infection and does not
usually work for longer than 6 months whereas an
AV fistula can be used for years.
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Recovery
The
incisions will be bandaged to keep the area
clean and prevent infection. You'll need to stay
in bed until the doctor says it's safe to get
up. For pain or swelling, you may put ice in a
plastic bag, cover it with a towel, and place it
over the incision for 15 to 20 minutes out of
every hour as long as necessary. Do not sleep on
the ice pack. Treatment with ice is most
effective when started right after surgery and
used for 24 to 48 hours.
When you are allowed to bathe or shower,
carefully wash the stitches or staples with soap
and water. Then put on a clean, new bandage.
Change your bandage any time it gets wet or
dirty.
You'll need extra rest while you recuperate. Try
to gradually increase your activity each day,
resting whenever you feel it's needed. Avoid any
heavy lifting until your doctor gives the OK.
Keep the limb with the shunt in a comfortable
position. Don't sleep on it, or keep it bent for
long periods. If the shunt is in your arm,
exercise gently by squeezing a soft, spongy
rubber ball in your hand every day.
Always take your medicine exactly as directed.
If it doesn't seem to help, let the doctor know,
but keep taking it until told otherwise. If
you've been prescribed antibiotics, be sure to
use them up, even if you're feeling better. If a
medicine makes you drowsy, avoid driving or
using dangerous machinery.
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Risks
There
are always risks with surgery. Infection is a
possibility; and heavy bleeding could occur if
the shunt comes apart. If the shunt gets clogged
and can't be reopened, another one will have to
be installed. Nevertheless, without the shunt
and the cleansing dialysis it enables, a
build-up of waste products and toxins within the
body will eventually prove fatal.
Frequently Asked Questions
Q:
What is an Arterio-Venous Fistula?
A:
This is created internally and is used for
prolonged periods of time. This involves a small
operation to join an artery and vein, allowing
arterial blood to flow directly into the vein.
The blood vessels of the arm are usually chosen,
e.g. at the wrist or at the upper forearm. Due
to the arterial pressure, the vein will increase
in size and its walls will thicken. It takes
about 3 to 7 weeks for the fistula vein to
mature. It is then easier to put a needle into
this vein to allow blood to flow through the
dialyzer using the blood pump on the machine.
Q:
What is an Arterio-Venous Graft?
A:
The
arterio-venous graft (AVG) is an artificial
blood vessel used to join artery and vein. It is
used when the patient's own blood vessels are
too small for fistula construction. Often, these
patients are the elderly or have pre-existing
diabetes mellitus. The graft, which may be
either straight or looped, is close to the
surface of the skin for easier needle insertion.
The graft may be of an artificial material such
as polytetrafluoroethylene or Gortex, or can be
obtained from the patient's own body, e.g. the
vein in the thigh.
Grafts are most commonly placed in the upper
arm, lower arm, and thigh. Two to four weeks
should pass before the graft is punctured to
allow adequate healing and sufficient growth of
tissue to stabilize the graft.
The following list of Urology procedures are
performed at Beverly Hills Medical Group -
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