Quality in shunt surgery

Background: Systematic and complete documentation of the data from operations and the long-term results is essential to improve the quality of dialysis access routes. In Switzerland, the Swissvasc Register [1] 2.0 was established in 2019 with a special dataset on shunt surgery. These data for a tertiary hospital were now evaluated for the first time.Method: This was a monocentric retrospective analysis of all prospectively collected data from primary or newly created arteriovenous accesses in 2019/2020. The observational follow-up period was 12 months. The primary endpoint was the primary patency rate. The secondary endpoints are the primary assisted/secondary and functional patency, the number of reinterventions and postoperative complications.Results: A total of 76 AV accesses were included. The primary patency rate was 56.5%. The primary assisted/secondary patency rates were 82.9% and 76.3%, respectively. The functional patency rate was 51.3%. Overall, 17 (22.4%) patients had already received a hemodialysis catheter before the operation and 20 (26.3%) received a hemodialysis catheter perioperatively.Conclusion: The results of the primary, primary assisted and secondary patency were comparable with previously published data. The high rate of hemodialysis catheter implantations and the lack of documentation of data on postoperative catheter placement should be the reason for a better monitoring of catheter implantation and to avoid this by good timing. To guarantee a high quality of treatment it is necessary to have an interdisciplinary cooperation and a highly motivated AV access team to achieve a high quality of dialysis access surgery, especially in the long term.