How do I prepare for my arteriovenous (AV) fistula surgery?

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.

You can prepare for arteriovenous (AV) fistula surgery by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, previous surgeries, medications, and allergies at all times.
  • Getting preoperative testing as directed. Testing varies depending on your age, health, and type of anesthesia. Testing may include blood tests, special kidney tests, a chest X-ray, EKG (electrocardiogram), and other tests as needed.
  • Losing excess weight before the surgery through a healthy diet and exercise plan
  • If you have high blood pressure, talk to your doctor about how to control it before and after surgery. Good blood pressure control can help decrease your risk of complications with AV fistula surgery.
  • Not eating or drinking just prior to surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
  • Taking dialysis treatments and medications exactly as directed 

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your preoperative appointments. Questions can include:

  • Why do I need AV fistula surgery? Are there any other options for creating a dialysis access?
  • How long will the surgery take? When can I go home?
  • What restrictions will I have after the surgery? When can I return to work and other activities?
  • What kind of assistance will I need at home?
  • How do I take care of my AV fistula?
  • When will I start dialysis treatments using the AV fistula? How often will I need them?
  • How do I take my medications? 
  • How will you treat my pain?
  • When should I follow-up with you?
  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my arteriovenous (AV) fistula surgery?

Knowing what to expect can help make your road to recovery after arteriovenous (AV) fistula surgery as smooth as possible. 

How long will it take to recover?

You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.

AV fistula surgery is often an outpatient procedure, so you go home the same day. Some patients stay in the hospital for other kidney failure treatments. Your surgeon will determine how long you need to stay in the hospital or outpatient center based on your age, condition, and medical history. 

Recovery after surgery is a gradual process. Your arm may be sore for several days after surgery.  Recovery time varies depending on the procedure, your general health, age, and other factors. 

It generally takes several months for the AV fistula to heal, enlarge and develop enough for dialysis access. Once healed, you will see the thickened vein that is joined to an artery and feel a pulse in it. In the meantime, you may have dialysis treatments using a temporary venous catheter. This is a tube in your upper chest that connects the dialysis machine to your blood vessels.

Will I feel pain?

Pain control is important to healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes in any way because it may be a sign of a complication.