Further surveillance visits were scheduled at 4 and 10 months after transposition and at 6 to 12month intervals afterward. Basilic vein transposition for creation of arteriovenous fistula subscription required. Basilic vein transposition for creation of arteriovenous fistula. The brachial artery transposed basilic vein arteriovenous fistulas have been used as a primary, secondary. Utility of basilic vein transposition for dialysis access. Following stage one basilic vein transposition is not predictive of outcome in two stage basilic vein transposition mostafa gabr, md postdoctoral associate vascular surgery duke university medical center 2014 vasa symposium. This was a nonrandomised, retrospective study between january 2007 and january 2012 on 96 patients who were diagnosed with endstage. Open arteriovenous anastomosis by upper arm basilic vein transposition.
Transposition of the great arteries tga is the most common cyanotic congenital heart disease chd in newborns, with an incidence of 0. Patient should be evaluated by physical examination andor venography if needed. In general, the success rates of vein transposition av fistulae are similar to those of the conventional simple direct av fistulae. Aug 11, 2018 transposition of the great arteries is usually detected either prenatally or within the first hours to weeks of life. Severity of swing segment stenosis following stage one. Brachiocephalic fistula using basilic vein transposition is performed to provide access for chronic hemodialysis when the cephalic vein is not available. Financial disclosure i have no potential conflicts with this presentation. Additionally, the upper arm basilic vein is protected from repeated venipuncture given its deep location. Most of the patients these veins are preserved and it has a very good. Basilic vein transposition versus biosynthetic prosthesis. Longterm results of femoral vein transposition for.
To study the place of basilic vein transposition in providing longterm vascular access for patients needing longterm hemodialysis. The list of acronyms and abbreviations related to bvt basilic vein transposition. Harvesting the femoral vein may be timeconsuming when there are many tributaries. Basilic vein transposition is a feasible and a good method to make avf with autogenous vein. The vein was accessed with a red rubber tube, and tunnel was made with tunneling instrument, and the vein was brought very carefully preventing from twisting up to the brachial artery. Arteriovenous fistula using basilic vein transposition. Current procedural terminology arteriovenous anastomosis. Transposition of the great arteries disease reference guide. You will be redirected to the full text document in the repository in a few seconds, if not click here.
A modified technique of basilic vein transposition for. Basilic vein arteriovenous fistulas are an important and common option for hemodialysis access and require superficialization before use. Pdf merger lite is a very easy to use application that enables you to quickly combine multiple pdfs in order to create a single document. To improve the results of bvt, several technical modifications have been proposed, including procedure staging,5, 7 endoscopic basilic vein dissection, 6 partial basilic vein mobilisation,8, 11 superficialisation instead of formal transposition, 9 basilic vein dissection through skip incisions and transposition in onestage procedure 10 and. Transposition of cephalic vein to rescue hemodialysis access. Then, the vein was transposed in the upper arm by making three contralateral incisions. Due to its profound localization, the basilic vein is less punctured and therefore remains a good reserve vein for vascular access. Dec 06, 2017 patient with chronic renal failure who has no other veins left for av access is best treated with basilic vein transposition. Basilic vein transposition william patrick, fracs, sydney, australia james may, ms, fracs, sydney, australia there is general agreement that a radiocephalic ar teriovenous fistula at the wrist is the preferred method of obtaining access to the circulation. In some cases, due to the longer period needed before cannulation.
The results indicate that the twostage bvt fistula through two skiparm incisions is superior to the established onestage procedure in terms of less morbidity but at the cost of a second operation and longer time to access use. Pdf upper arm basilic vein transposition for hemodialysis. The procedure was accomplished without intercurrent conditions and, after surgery, the. Basilic vein transposition for creation of arteriovenous. At the end of surgery, we observed a thrill in the transposed cephalic vein necklace and also at the brachiobasilic avf. To modify the technique of basilic vein transposition for vascular accesss for haemodialysis aiming at better maturation rate, longer survival of fistula and lesser complications. Basilic vein transposition fistula creation sample report.
This is a xxyearold hispanic female who presented for second stage of basilic transposition in the left arm. Patient demographics and past medical history were similar between the groups, but stenting procedures were more likely to be performed in. Apr 26, 2017 transposition can also be done for veins that may be superficial enough but not positioned for safe cannulation. Small incision basilic vein transposition technique. Transposition of the great vessels tgv is a group of congenital heart defects involving an abnormal spatial arrangement of any of the great vessels.
The common feature is that the connections between the heart and main arteries the aorta carrying blood to the body, and the pulmonary artery carrying blood to the lungs are abnormal. Brachiobasilic arteriovenous fistula with transposition of. Each technique may have advantages and disadvantages, and there have been few reports directly. Jan 11, 2011 one of the veins used for an avf is the basilic vein, located at the upper arm. Basilic vein transposition versus biosynthetic prosthesis as vascular access for hemodialysis massimo morosetti, md, asilvia cipriani, md,b sara dominijanni, md,c giovanni pisani, md, daniele frattarelli, md, aand fabrizio bruno, md, rome, italy background. Transposition of the great arteries tga is a cyanotic congenital heart defect in which the aorta arises from the right ventricle and the pulmonary artery arises from. Brachiobasilic arteriovenous fistula, or basilic vein transposition bvt, is frequently used in hemodialysis access with the benefit that the basilic vein is typically of a larger size than its companion, the cephalic vein. Vascular access va complications account for a signi. Apr 11, 2017 transposition of the great arteries tga is the most common cyanotic congenital heart lesion that presents in neonates. The basilic vein transposition was the initial angioaccess procedure in only 25% of cases and secondary in 75%.
Retrospective casecontrolled study, performed in an academic centre. Having a baby with transposition of the great arteries can be alarming, but with proper treatment, the outlook is promising. Herein, we introduce a surgical technique to make a basilic vein transposition with minimally several skin incisions. The brachiobasilic avf with transposition of the basilic vein is a welldocumented and feasible third option in the management of vascular access. Three additional patients underwent exploration of an inadequate basilic vein with. We have nationally recognized programs and treat many types of pediatric conditions. Transposition of the great arteries tga is associated with several different arrangements of heart anatomy, so is not one condition. Levotransposition of the great arteries is an acyanotic congenital heart defect in which the primary arteries the aorta and the pulmonary artery are transposed, with the aorta anterior and to the left of the pulmonary artery. To find a less morbid option of basilic vein transposition jairath et al compared minimal invasive bvt 30 patients with conventional bvt 34 patients in terms of post op morbidity. Pdfdateien in einzelne seiten aufteilen, seiten loschen oder drehen, pdfdateien einfach zusammenfugen oder. See essential instructions from icd10pcs official guidelines for coding and reporting right on your code details page. Transposition of basilic vein with minimal incision. Pdf zusammenfugen online pdf dateien zusammenfugen. Utility of basilic vein transposition for dialysis.
Lallall tgal ivs tga with intact sptum t1mustards196373t2mustards197485karterial switch. The national center for biomedical ontology was founded as one of the national centers for biomedical computing, supported by the nhgri, the nhlbi, and the nih common fund under grant u54hg004028. Though basilic vein transposition is well established in multiple failed fistulaes and obese patients, it requires large incision and morbidities like edema and infection. Trial comparing onestage with twostage basilic vein. Congenital heart diseases involving only the primary arteries pulmonary artery and aorta belong to a subgroup called transposition of the great arteries. The basilic vein was then transected in the antecubital region, all branches were ligated, and the vein was transposed through a subcutaneous lateral tunnel, with care to avoid axial rotation. So if you are looking to learn the latest surgical procedures or share your latest surgical knowledge, feel free to browse, learn, share and discuss all for free. Small incision can be applied to basilic vein transposition, which can be less painful and more comfortable to the patients. Prostaglandin e1 infants with ductus arteriosusdependent congenital heart disease. Transposition of the great arteries tga is a cyanotic congenital heart defect in which the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle, creating two parallel circuits. The patient who experienced primary failure is being assessed for surgical suitability for a basilic vein transposition procedure two previous av access failures and a history of central stenosis, and the second patient is being assessed for a transposed basilic vein fistula, pending investigation of hypercoagulability two previous av access failures. Fistulas created with a transposed basilic vein sutured end to side to the brachial artery have been shown to be the most reliable and dependable secondary vascular access procedure. Basilic vein transposition bvt fulfills the need for a durable conduit with high patency and maturation rates. Creation of left basilic vein transposition fistula.
Relocation of arm vein with connection to arm artery, open procedure. Various superficialization techniques have been employed, such as basilic tunnel transposition btt, basilic elevation, and basilic elevation transposition bet. Patient with chronic renal failure who has no other veins left for av access is best treated with basilic vein transposition. To compare the outcome of the onestage basilic vein transposition bvt fistula with a modified, twostage technique. The hallmark of transposition of the great arteries is ventriculoarterial discordance, in which the aorta arises from the morphologic right ventricle and the pulmonary artery arises from the morphologic left ventricle. A modified technique of basilic vein transposition for haemodialysis farid ahmad chaudhary1 and zahid parvez2 abstract objective. Basilic vein transposition bvt was first described in 1976 and has been increasingly accepted as a viable option for secondary or tertiary vascular access. What are vein transposition av fistulae and how successful. What is critically important is that vein transpositions have expanded the av fistula opportunities and options for patients who would otherwise receive an av graft or catheter if only the more conventional. Basilic elevation transposition may improve the clinical. This chapter describes indications, essential steps, variations, and complications of this procedure. Upper arm basilic vein transposition for hemodialysis. Nemours is committed to providing familycentered care within our hospitals and clinics. A total of 173 candidates for bvt fistula 87 males, mean age 61 years.
Transposition of the basilic vein and anastomosis with the brachial vein onestage vs twostage transposition of the basilic vein. Dieses kostenlose tool erlaubt es mehrere pdfs oder bilddateien miteinander zu einem pdfdokument zu verbinden. Nassar, gerald beathard, edward rhee, abduljabbar khan, binh nguyen. Surgery theater, with more than 12,000 educational surgery videos, is the worlds first online social medical video sharing for all health care professionals. Management of transposed arteriovenous fistula swing point. Elevation of brachiobasilic fistula is an accepted variation of basilic vein transposition bvt. Go to top of page study description study design arms and interventions outcome measures eligibility criteria contacts and locations more information. Read the aha coding clinic icd9cm newsletter article titled. This vein is however deeply located and necessitates transposition during surgery to a less deep and lateral subcutaneous plane before the anastomosis with the artery, in order to be used. Arteriovenous fistula using transposed basilic vein is a suitable procedure that should be considered as one of the options for longterm vascular access in patients with chronic renal failure requiring hemodialysis. No need to flip from a code to the front of a book or to hunt through online pdfs to locate applicable chapter and block specific guidelines.
To avoid such compilations we, at our institution, adopted a small incision technique using two small 34 cm incisions. This study aimed to compare the results of oneand twostage basilic vein transposition bvt in haemodialysis patients. Transposition of basilic vein with minimal incision journal. Kakkos sk1, haddad gk, weaver mr, haddad rk, scully mm.
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