Failed Fistula

[Sapphire187]

Six weeks ago I had surgery to get a brachio-basilic fistula in my left arm. I went for my first post-op follow-up appointment yesterday. First they did an ultrasound on the fistula. I was supposed to be scheduling the surgery to do the transposition of the fistula. Instead I was told that the fistula was occluded and failed and there was nothing they could do to fix it. 🙁 The surgeon said I have two options. I can get a graft in my left arm from my elbow to shoulder or they can try to do a brachio-basilic fistula in my right arm (my dominant arm). None of my other veins are suitable. She (Surgeon) said my basilic vein is small. She said the graft will only last about two years and I will likely have multiple complications during that time requiring surgical procedures because grafts are more prone to blood clots, infection and pseudo aneurisms. She told me to think about it for a week and then call her office to schedule the surgery. She told me twice she didn’t need to see me for another appointment and to just call. I wasn’t expecting that news and of course thought of many questions after the appointment ended. I’m not sure what to do. I’m afraid to try the same fistula in my right arm for fear of it failing. Not to mention it’s my dominant arm and they didn’t do vein mapping on that arm. Oh, and my left arm is still numb from my elbow to my wrist, and she said it might eventually get better or it may never get better. I wonder if my fistula could have been saved if they had checked my fistula earlier. I had called the vascular office on day 7 and day 10 with concerns about not feeling the thrill and was told not to worry about it. I would really appreciate hearing others experience with a graft. Anyone else have a failed fistula surgery? What did you do? Thank you.

[Bassetmommer NKF Ambassador]

Get a second opinion. This all sounds kind of strange to me and the fact that they did not want to see you when you called is also concerning.

[bumblebee_tuna in reply to Bassetmommer]

Yeah ^^^

[horsie63]

My fistula never worked. They ended up putting in a graft and it's worked fine since.

[Sapphire187 in reply to horsie63]

Hi Horsie63, How long have you had your graft? Is your graft in your upper or lower arm? Did they tell you it would only last about two years? I’m glad you haven’t had any problems with your graft. Thanks.

[horsie63]

I've had it since Apr 2024. It's in my upper arm. Nobody told me it would only last 2 years. I do everything I can to keep it safe.

[ShyeLoverDoctor]

I am very sorry you have experienced this.

There is no excuse for the office not calling you to come in when you report no thrill on day 7. They tell you to check your thrill daily to be sure it is still strong! Your first follow up was 6 weeks later? I saw my surgeon after one week.

This sounds to me (I am not a doctor) to be an highly inappropriate standard of care.

I would write down all of these details before any more time passes and start keeping a record of all calls to this office of who you talk to.

Most definitely this is worth a complaint to the medical board, if not (I am not a lawyer ) grounds for malpractice. No surgeon can guarantee a working fistula, but not calling you in to examine you is negligent. I highly recommend speaking to a medical malpractice attorney, but it’s your choice.

I am aware bringing a medical malpractice lawsuit wouldn’t be pleasant, but a lawyer will not take this on contingency (where you pay nothing but the lawyer takes big chunk of the settlement) unless they think they can win.

Demand a vein mapping of your other arm. It’s a half hour or one hour appointment. My surgeon happened to have that machine in his office, but not every surgeon will. Travel to another office or hospital or medical center if you have to.

Grafts are not as good but I think it’s wrong to assume they will fail quickly.