Diva Saphira, - (2022) Correlation Between Intraoperative Blood Vessel Diameter and Technical Success Rate of AV Shunt Surgery in Dr. Soetomo Hospital Surabaya. Skripsi thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Background: An arteriovenous (AV) shunt is a connection or anastomosis between vein and artery made in a surgical procedure as vascular access indicated for patients with end-stage renal disease (ESRD) that are projected to undergo routine hemodialysis or have undergone initiation of hemodialysis with a central venous catheter (Lok, 2020). Unfortunately, AVF maturation failure and AVG thrombosis remain major clinical problems for hemodialysis patients as 20% to 60% of AVFs created fail to mature successfully for dialysis use (Lok, 2020). The cause of most early AV shunt failure in general is still unknown, but the quality of the blood vessels is suspected as a factor (Nagarik, 2020). Many preoperative, intraoperative, and postoperative parameters influence the success of AV shunts. Currently, few clinical pathways are used to predict the success of access maturation for AV shunt creation, and the impact of the vessel diameter was researched in numerous studies. However, postoperative vessel diameter as an AV shunt surgery success predictor has not been researched as much as the preoperative measures. Aims: This study aims to learn and determine the correlation between blood vessel diameter and the success of AV shunt surgery. Methods: This research uses a descriptive-analytic research design. The sample includes all patients who have undergone AV shunt surgery from January 2019 – December 2020 which matches the inclusion and exclusion criteria at Dr. Soetomo General Hospital. The dependent variable is the success of the AV shunt surgery and the independent variable is the diameter of the vein and the diameter of the artery. Results: AV Shunt surgery in radiocephalic region is 27 (43.55the %), brachiocephalic region is 32 (51.61the %), and brachiobasilic region is 3 (4.84%). Vein diameter <2 mm (8.06%), 2 - <4 mm (79.03%), 4 - <6 mm (11.29%), ?6 mm (1.61%). Artery diameter <2 mm (4.84%), 2 - <4 mm (64.52%), 4 - <6 mm (25.81%), ?6 mm (4.84%). Successful surgery for vein diameter <2 mm (8.62%), 2 - <4 mm (77.59%), 4 - <6 mm (12.07%), ?6 mm (1.72%). Successful surgery for artery diameter <2 mm (5.17%), 2 - <4 mm (63.79%), 4 - <6 mm (25.86%), ?6 mm (5.17%). The results of the Chi-Square analysis found no significant correlation between vein diameter and success of AV shunt surgery (p=0,769), and no significant correlation between artery diameter and success of AV shunt surgery (p=0,922) at Dr. Soetomo Hospital, Surabaya 2019-2020. Conclusion: This study did not find a correlation between vein or artery diameter and the success of AV shunt surgery based on the postoperative evaluation of bruit, thrill, and pulsation.

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