HeRO graft

The HeRO graft is a haemodialysis access designed for patients whose central chest veins are occluded, who cannot have a conventional fistula in the arm and depend on a catheter.

How does it work?

It is a hybrid device with two parts: a prosthetic tube connected to an arm artery, as in a graft fistula, and a segment that runs through a central vein directly to the heart (right atrium). In this way it “bypasses” the blocked veins and blood returns to the heart without passing through them.

Who can benefit?

• Patients who depend on a permanent catheter because their central veins are occluded.
• Patients whose fistulas or grafts fail repeatedly because of central venous obstruction.

Advantages over a catheter

A long-term catheter carries a high risk of bloodstream infection. In the initial published series with HeRO, the bacteraemia rate was clearly lower than that reported with tunnelled catheters, and dialysis was more effective. In addition, the patient has no catheter coming out through the skin.

The procedure

It is performed in the operating theatre, combining X-ray-guided endovascular techniques to place the venous segment with minor surgery in the arm to connect it to the artery. It requires a short hospital stay and joint follow-up with the dialysis unit.

References

Patient information reviewed by Dr Óscar Merino, vascular surgeon. It does not replace an individual medical assessment.