AV Fistula Question

[LizzzyLizzzard]

Hi Everyone

I was hoping to get some feedback on other with AV Fistulas that have heart problems as well.

My Dad is 74 and was scheduled for an AV Fistula surgery today, I chicken out and cancelled the surgery.  I have read online that the Fistula puts strain on the heart, my Dad has an aortic aneurysm.

he is on BP meds, blood thinners and cholesterol meds as well.  He has never smoked.

He has had 15% Kidney Function for about a year and still feels ok.

I am so worried that the Fistula would cause the aneurysm to rupture.

Does anyone else have experience with this scenario? I am so scared

Thanks

[obsidianom]

Only his own vascular surgeon can answer that as the surgeon can look at the aneurism via ultrasound and /or MRI etc.  What did the surgeon say?  The problem with no fistula is that if he needs dialysis and doesn't have a fistula , he has to start with a more dangerous catheter which goes almost directly into the right side of the heart and can lead to infections . So you and the vascular surgeon have to look at his individual case and weight he benefits and risks.

[Michael Murphy]

While I don't have a aneurism I have had a heart attack and have had a fistula for 5 years with out a problem.

[LizzzyLizzzard]

The surgeon is ready to proceed and did not mention any concern with the aneurysm, he is a kidney transplant surgeon for the hospital.  I was told that he is the best surgeon to do the Fistula.  They mentioned to me that they would monitor the flow on a monthly basis once he starts dialysis to ensure that the flow is not too strong, if the fistula gets too big it may cause problems with the aneurysm.  I also contacted my dad's cardiologist and he referred us back to the kidney clinic and says they know what they are doing.

I didn't know that the catheter is more dangerous.  Sounds like the Fistula is the safest option.

Thanks for the responses I have asked the access coordinator to reschedule the surgery.

[ramlamb57]

A permacath, as it is deceptively called, is not permanent. You will have to get some other access eventually, and it has danger of infecting the heart. I'm sure if he has an AAA, he will be required to undergo "watchful waiting", and it will be treated when it reaches a certain size. Just listen to his doctors, and he will be fine. Good luck   

[Hootie]

We used the fistula and according to everything I read it is the "gold Standard" for access. Just make sure that you get the surgery done well in advance of needing it for dialysis. The fistula takes some time to heal and mature. Most say 10-12 weeks before you need it is best. With it being mature, its a little larger and easier to stick the arterial and veinous access points for the caregiver or the in center technician/nurse,  if you go that route.  We had some issues sticking as we used it at 7 weeks.  Now it works almost perfect.  All us have the fears at the beginning but it slowly goes away as you get confidence in what you are doing. That is true for all types of dialysis.

Most all of us agree the the fistula is the way to go for us. There are exceptions so discuss with the Nephrologist and surgeon as what is best for you and more importantly. your Dad. 


Joe

[LizzzyLizzzard]

I feel better now thank you, there is so much scary information on the internet.  I am glad to have found this forum.

The plan is to get the fistula surgery now for future use.  I will have to ensure that the aneurysm is routinely checked for size changes hopefully  it never does

[Vt Big Rig]

I would add.      As soon as he feels comfortable squeeze a ball in that hand. I should have done more of that.. My fistula was a year old before we needed to use it and we had many issues with it. Four fistulagrams later iit seems to be working OK.