Modified use of the Hemodialysis Reliable Outflow (HeRO) graft for salvage of threatened dialysis access.
The Hemodialysis Reliable Outflow (HeRO) graft (Hemosphere Inc, Eden Prairie, Minn) offers a new option to provide upper extremity arteriovenous (AV) dialysis access in patients with central venous occlusive disease. Creative use of this device can allow for salvage of failing or threatened AV fistulas and grafts. We present two patients who underwent a modified implantation of the HeRO device for immediate salvage of a malfunctioning AV access. Ipsilateral central venous occlusions were successfully overcome by anastomosing a HeRO device to the existing AV access and tunneled across the chest to the contralateral internal jugular vein.
Division of Vascular and Endovascular Surgery, University of Miami, Miller School of Medicine and Bruce W. Carter Miami VAMC, Miami, FL, USA.
Bassan J
BJ
Allan
Angela T
AT
Prescott
Marwan
M
Tabbara
Arash
A
Bornak
Lee J
LJ
Goldstein
D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000295:instrumentation; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis; D062666:Vascular Access Devices