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CASE 6-16B Operative Report, Arteriovenous Fistula LOCATION: Outpatient, Hospital fashion took down tributaries of the artery. Once we had both vessels PATIENT: Maggie Sodium well immobilized, we brought them together with vascular loops, gave the SURGEON: George Orbitz, MD patient 5000 units of heparin, and then performed a primary anastomosis between the artery and vein using 6-0 Prolene. With completion of the PREOPERATIVE DIAGNOSIS: Chronic renal failure anastomosis, there was excellent flow with a palpable thrill. We ligated POSTOPERATIVE DIAGNOSIS: Chronic renal failure three tributary branches of vein to increase the flow up the arm. We PROCEDURE PERFORMED: Placement of primary arteriovenous fistula, passed a Fogarty catheter all the way up the arm and then gently pulled left wrist it back with the balloon partially inflated to dilate the vein. This showed ANESTHESIA: General that we had a patent vein all the way up the arm and that we were able to dilate the vein back down to the anastomosis. This Fogarty catheter was PROCEDURE: With the patient under general anesthesia, the arm was introduced through the distal venous segment, which was then ligated marked for the vein. There was a fairly large cephalic vein at the wrist on using 2-0 silk. On completion of the procedure, the patient had an intact the left, but we are not certain as to whether there was a continuous vein vascular anastomosis with good flow documented to the hand in both the going up the arm. We then prepped and draped the arm. We first made a radial and ulnar arteries. The patient had a palpable thrill going up the small incision about midway up the forearm over an area where we could lower portion of the arm. The incisions were then closed using an inner no longer palpate the vein. After marking this incision and freeing up the layer of 3-0 chromic and a skin layer of 4-0 nylon. Sterile dressings were vein in this location, we could see that there was an adequate vein going applied. The patient tolerated the procedure well and was discharged from up to just below the elbow. With this in mind, we then made an extended the operating room in stable condition. incision at the wrist and were able to mobilize the cephalic vein toward the radial artery. We were also able to free the radial artery. We took down SERVICE CODE(S): some tributaries of the vein with 4-0 silk ligatures and then in a similar ICD-10-CM DX CODE(S):

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