A 55-year-old female presenting with central venous stenosis

Abstract

Introduction: Patients who have failed arteriovenous grafts (AVG) and arteriovenous fistulas (AVF) and are central venous catheter (cVc) dependent have a new option for hemodialysis access: the hemodialysis reliable outflow (HerO) graft. Our patient required hemodialysis for end-stage renal disease (EsrD) secondary to uncontrolled diabetes. case report: A 55-year-old female presented with multiple AV fistula and AV graft failures due to venous outflow obstruction. she was catheter-dependent for hemodialysis access with evidence of central venous stenosis. the patient also presented with ventilator-dependent respiratory failure on pressure support ventilation and recurrent pleural effusions due to volume overload. With all other options exhausted, she underwent HerO graft placement complicated by postoperative steal syndrome, and multiple thromboses. conclusion: the HerO graft is an option for long-term hemodialysis access for patients who are refractory to traditional approaches and are catheter-dependent. thrombosis and steal syndrome may be more common complications of the surgery than previously suspected, but may be manageable if caught early. In comparison to central venous catheters, with the HerO graft, infection rates are reduced and flow rate can be