title: Right Brachial to Atrial Xenograft Conduit for Hemodialysis Access: A Case Report.
abstract: Biologic grafts may be a viable alternative to their prosthetic counterparts in the patients who have exhausted conventional access alternatives given their superior patency rates and possible resilience to infection. This is a case report of a 66-year-old woman with end-stage renal disease and human immunodeficiency virus who has had multiple failed peripheral arteriovenous (AV) fistulas and grafts as well as inferior vena caval obstruction necessitating a transhepatic catheter for hemodialysis (HD). Given the patient's comorbidities and history, a right brachial artery-to-atrial conduit was created for long-term access. Biologic bovine carotid artery was used given its decreased susceptibility to infection and favorable patency rates. The AV access continues to function at 3.5-year follow-up and remains her primary means of HD. We present this novel use of a biologic graft as an option in patients with central venous obstruction and high risk of infection requiring exotic dialysis access.
authors: Division of Vascular & Endovascular Surgery, Houston Methodist Hospital, Houston, TX. Electronic address: etonylu@gmail.com.
authors: Tony
authors: T
authors: Lu
authors: Division of Vascular & Endovascular Surgery, Houston Methodist Hospital, Houston, TX.
authors: Javier E
authors: JE
authors: Anaya-Ayala
authors: Division of Cardiovascular & Thoracic Surgery, Houston Methodist Hospital, Houston, TX.
authors: Michael J
authors: MJ
authors: Reardon
authors: Division of Vascular & Endovascular Surgery, Houston Methodist Hospital, Houston, TX.
authors: Eric K
authors: EK
authors: Peden
authors: Division Vascular & Endovascular Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors: Mark G
authors: MG
authors: Davies
mesh_terms: D000368:Aged; D000818:Animals; D001166:Arteriovenous Shunt, Surgical; D001807:Blood Vessel Prosthesis; D001916:Brachial Artery; D002417:Cattle; D005260:Female; D006325:Heart Atria; D064593:Heterografts; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis