Overview
An artificial connection is created between a vein and an artery in order to create a sufficiently high blood flow for blood washing. There are two types: the direct connection between the artery and vein (native shunt) and the connection via a plastic prosthesis (see illustration).
A freshly installed dialysis access usually needs some time to mature; an artificial shunt needs time to grow in firmly. The operation should therefore be performed several months before the start of dialysis if possible.
Arterio-venous (A-V) fistula (native shunt)
The A-V fistula is a surgically created short-circuit connection between the artery and vein. After about four to six weeks, the vein adapts to the increased blood flow and pressure (maturation).
Plastic prosthesis
In the case of unfavorable vein conditions, a plastic prosthesis is used as a connection between the artery and vein. This shunt can be used for dialysis after just two weeks.
Procedure of the operation
Preparation
If your nephrologist has determined the need for dialysis, the clinical status of your blood vessels will be comprehensively assessed in an initial outpatient consultation and the most suitable dialysis access will be evaluated together with you. Blood should then no longer be taken via the future shunt vessel in order to protect it from vessel wall injuries. Dialysis shunt training should start around twelve weeks before the operation.
Surgery
The operation is performed by an experienced team of specialists. Depending on the medical situation, the procedure can be performed on an outpatient basis or with a short inpatient stay. In most cases, a local anesthetic is sufficient.
Aftercare
Follow-up appointments follow the operation. Your nephrologist and the treatment team will support you in continuing your dialysis shunt training and in the correct care of your dialysis access.
Further services
- Installation of dialysis catheters
- Checking dialysis shunts in the event of problems
- Surgical corrections for malfunctions
- Vascular imaging usingCO2 as a contrast agent, i.e. without conventional contrast agents that are harmful to the kidneys
Material for patients and referring physicians
