2012 Volume 52 Issue October Pages 337-341
A 69-year-old woman with chronic renal failure was referred to our department because of repeated problems with her arteriovenous access. She had no suitable veins for creating a new areteriovenous fistula in either of her upper limbs. She had congestive heart failure (CHF) due to valvular heart disease and myocardial ischemia. Therefore, there was a strong possibility that creating a conventional areteriovenous fistula with a prosthetic graft would worsen her condition due to volume overload. There was also a possibility that general anesthesia would cause cardiogenic shock. Accordingly, we inserted an arterioarterial prosthetic loop (AAPL) into the left superficial femoral artery (SFA) under local anesthesia. There were no procedural complications, and she continued to undergo hemodialysis until she died from cardiopulmonary arrest 173 days after the operation. Use of an AAPL in the SFA for hemodialysis access is a worthwhile option in patients with CHF.
