donnagullikson
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I have a hard time coding these revisions and could use a little help with this one. This is a long report.
A transverse incision was created over the outflow vessel near the left axilla with a #10 blade scalpel and carrieddown through the subcutaneous tissue. The AV fistula was circumferentially dissected in the left upper arm to control the outflow and a vessel loop was placed around the AV fistula. Next, a longitudinal incision was created along the arterial aspect of the left upper extremity AV fistula, carried down through the subq tissue where the brachial artery anastomosis was encountered and circumferentially dissected and controlled with vessel loop. Next the arterial aspect of the AV fistula was clamped using a profunda femoris clamp. The outflow vessel was also clamped through a separate incision with a profunda femoris clamp. The AV fistula was divided with curved scissors and an 8 mm PTFE graft was tenneled in the left upper arm subq tissue lateral to the aneurysmal AV fistula. The anastomosis was created in an end-to-end fashion using 6-0 Prolene suture in a running circumferential fashion. Following arterial reconstruction, t he AV graft was stretched to appropriate length and transected. PTFE was sewn to the venous outflow aspect using 6-0 Prolene suture in a running circumferential continuous fashion. Flow was restored through the interposition graft in the left upper arm
Thanks,
A transverse incision was created over the outflow vessel near the left axilla with a #10 blade scalpel and carrieddown through the subcutaneous tissue. The AV fistula was circumferentially dissected in the left upper arm to control the outflow and a vessel loop was placed around the AV fistula. Next, a longitudinal incision was created along the arterial aspect of the left upper extremity AV fistula, carried down through the subq tissue where the brachial artery anastomosis was encountered and circumferentially dissected and controlled with vessel loop. Next the arterial aspect of the AV fistula was clamped using a profunda femoris clamp. The outflow vessel was also clamped through a separate incision with a profunda femoris clamp. The AV fistula was divided with curved scissors and an 8 mm PTFE graft was tenneled in the left upper arm subq tissue lateral to the aneurysmal AV fistula. The anastomosis was created in an end-to-end fashion using 6-0 Prolene suture in a running circumferential fashion. Following arterial reconstruction, t he AV graft was stretched to appropriate length and transected. PTFE was sewn to the venous outflow aspect using 6-0 Prolene suture in a running circumferential continuous fashion. Flow was restored through the interposition graft in the left upper arm
Thanks,