The Left

brachial or A.radialis end was to side” performed and distal anastomosis, in the area of the wrist with the A. radialis end to end “applied. In other cases, the proximal connection with the A. was to side brachial final”carried out, then the proximal section of the A. radialis, immediately after the departure of the A.brachialis visited and ligated.

The distal anastomosis to side in the area of the wrist with the A. radialis end “created. While the venous Interponat continued subcutaneously and radial side.(Figure 2). Figure 2 was schema of the operation if the patient had a Decompensated AVF, carried out the operation as a reconstructive surgical procedure in two stages (Figure 3). Figure 3 schema of the operation until after the proximal anastomosis system followed the severing the artery distal AVF, while the arterial-venous blood flow was not interrupted still, however already reduced. The distal section of the artery is sewn with the Interponat end to end. In this case the graft was arranged subcutaneous and ulnarseitig, located by the arterialisierten V.cephalica, to prevent bleeding complications in the operation and a return flow of disability during dialysis. Two weeks after the procedure, if the new vascular access is already operational, the left surrounded loving arterial-venous connection will be cut.

During dialysis, blood from the venous Interponat was taken. The repatriation is carried out in the peripheral, already arterialisierte vein in the forearm. All surgeries were performed under the brachial plexus. Results: A subcutaneous lying Section of the vessel is a great way to carry out the adequate blood wash (KT/V 1.6 0.2). The primary hydraulic extended venous graft was easily accessible for the implementation of the puncture. During dialysis, blood flow was 303 5.4 ml/min (AVF 281 8.5 ml / min). The pressure of the blood pump was 65 8.1 mmHg (mmHg with AVF-140 7.8). A reduction in peripheral vein without arterial-venous connection completely ruled out the possibility of a recirculation. Table 1 Dynamics characters of echocardiography after the closure of the AVF and implementation of dialysis treatment with the help of new vascular access. N control n = 12 AVF = 19 shunt n = 19% 1%? 2 RR (mm Hg) 92, 72. 3 118, 82, 8-105, 12, 4 + 22% p < 0.001-11, 5% p < 0.001?(g / l) 137, 21, 9 80, 32, 2 86, 03, 2-42% p < 0.001 + 6.6% p > 0.05 computer (ml) 115, 04, 5 155 48, 4-127, 58, 2 + 26% p <0,001 -18% p <0,02 ESV ( ml ) 43,63,4 67,17,5 52,44,4 +35,0% p <0,01 -21,9% p <0,001 SV (m l ) 68,43,2 92,26,0 74,94,7 +26,0% p <0,001 -18,8% p <0,001 Si ( l/min ) 2,90,1 4,20,3 3,70,2 +31,0% p <0,001 -12,0% p >0,05 HMV (l/ min ) 5,10,2 7,10,5 5,80,4 +28% p <0,001 -18,3% p <0,05 IVS (s m ) 0,90,03 1,30,06 1,20,05 +30,8% p <0,001 -7,7% p >0,05 HW (sm) 0,90,03 1,20,04 1,20,05 +25,0% p <0,001 0% p >0,05 RV (s m ) 1,50,1 1,80,08 1,90,1 +16,7% p <0,001 +5,3% p >0.05 LV (s m m) 4. 90., 1 5, 60, 1 5, 20, 1 + 12.5% p < 0.001-7.2% p < 0.01? 1 significant difference of characters of Central hemodynamics between the control group (healthy people) and