Specific Cases of Urgent Vascular Surgery and Peculiar Characteristics of Bypass Operations
Journal Title: Surgery & Case Studies: Open Access Journal - Year 2019, Vol 2, Issue 1
Abstract
Until March 2018 the work with grafts for the hemodialysis had not posed any complications. Prosthetic devices were removed in connection with urgent suppurate processes or routinely, both when thrombosed grafts existed as a heterogeneous body and when they could prevent carrying out other arterio-venous fistulas. But during only one month – April 2018 there were diagnosed three cases of pulsating hematomas from arterio-venous grafts in the shoulders. In all these cases patients needed surgery. I, myself, performed 2 operations. In one case the patient was hospitalized to another clinic. In the first event the artery and anastomosis with a. braсhialis had a long linear rupture on the back side of the artery. The artery and graft were singled out in both directions from the zone of anastomosis and were taken on the holders. They were clamped but the bleeding did not stop. The situation was complicated by the anamnesis of the patient: there were numerous thromboses of vessels, diabetes type I, polyfactor thrombophilia; so we could not rely on the tourniquet for a long time, moreover the ejection fraction was reduced significantly, and if we had to clamp the artery for any long period then there could be only one way out - the amputation. The graft turned out to be with multiple big, merging with each other point defects in its middle third part. Then the graft was knotted and extracted. The brachial artery was with ragged edges and a linear defect about 3 centimeters long. The artery could not be linked to its edges by stitching its walls together. That is why the autovein was singled out, the transplant was formed, and artery plastic was performed. Finally, the vessels were functioning properly.
Authors and Affiliations
Drozdova EV
Keywords
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- EP ID EP639935
- DOI 10.32474/SCSOAJ.2019.02.000130
- Views 67
- Downloads 0
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