Brachio- Axillary Translocation Fistula with Reverse Saphenous Venous Graft: a New Hope for the Patients of End stage Renal Disease

  • SMG Saklayen Russel Assistant Professor and Associate Consultant, Dept. of Vascular Surgery, Ibrahim Cardiac Hospital and Research Institute, Dhaka
  • Jubayer Ahmad Registrar, Dept. of Vascular Surgery, Ibrahim Cardiac Hospital and Research Institute, Dhaka
  • Raju Ahmed Assistant Prof of Anaesthesia, Ibrahim Cardiac Hospital and Research Institute, Dhaka
  • Jashim Uddin Registrar, Dept of Anaesthesia, Ibrahim Cardiac Hospital and Research Institute, Dhaka
  • Suman Nazmul Hosain Head of the Department of Cardiac Surgery, Chittagong Medical College & Hospital, Chittagong
Keywords: Arteriovenous fistula, autogenous AVF, graft AVF, Great Saphenous Vein

Abstract

Native arterio-venous fistula (AVF) are the preferred mode of repeated vascular access for the chronic renal failure patients surviving on hemodialysis because of their easy accessibility, good long term patency, low complication rate and cost-effectiveness. Creation of a fistula between the radial or brachial artery and a suitable adjacent vein is the most commonly practiced option. However the major upper arm veins of the CKD patients are often found thrombosed, cord like and not suitable for AV anastomosis. A 48 years old male patient of chronic kidney disease with a permanent catheter placed in the right subclavian vein was referred to create an AV fistula. On exploration none of the upper limb veins was found suitable for fistula formation. The proximal part of the left GSV was harvested from patient’s left upper thigh and was used to make a connection between left brachial artery at cubital fossa and the left axillary vein. To avoid over flooding of the limb vasculature, partial banding of the left axillary vein was done distal to this anastomosis. When all options in both upper limbs are exhausted, autologous great saphenous grafts may be a very useful tool for the surgeons in creating upper limb AV fistulas in difficult situations

Bangladesh Heart Journal 2018; 33(2) : 134-137

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Author Biographies

SMG Saklayen Russel, Assistant Professor and Associate Consultant, Dept. of Vascular Surgery, Ibrahim Cardiac Hospital and Research Institute, Dhaka

Dept. of Vascular Surgery

Jubayer Ahmad, Registrar, Dept. of Vascular Surgery, Ibrahim Cardiac Hospital and Research Institute, Dhaka

Dept. of Vascular Surgery

Jashim Uddin, Registrar, Dept of Anaesthesia, Ibrahim Cardiac Hospital and Research Institute, Dhaka

Dept of Anaesthesia

Suman Nazmul Hosain, Head of the Department of Cardiac Surgery, Chittagong Medical College & Hospital, Chittagong

Department of Cardiac Surgery

Published
2018-12-28
How to Cite
Russel, S., Ahmad, J., Ahmed, R., Uddin, J., & Hosain, S. (2018). Brachio- Axillary Translocation Fistula with Reverse Saphenous Venous Graft: a New Hope for the Patients of End stage Renal Disease. Bangladesh Heart Journal, 33(2), 134-137. https://doi.org/10.3329/bhj.v33i2.39310
Section
Case Reports