I have a catheter. I have had it for 15 months (it was placed after I had a triple heart bypass). My problem is that my veins in my arm are to small for a fistula. My Doctor put one in my arm. It didn’t work and there were so much pain in my arm and I lost circulation in the arm. The Doctor went back in and closed it off and started circulation again. The veins in my right leg were used for the bypass. My question is can the catheter be moved from side to side in my chest. The one that being used is one that can stay for 2 yrs. I have an appointment with another vascular Doctor in July.

The best vascular access for long term hemodialysis is a fistula.  A fistula is associated with the best life expectancy compared to any other option that might be available. If you are eligible for a kidney transplant, that would be in your overall best interest, however, given the heart difficulties, it is unclear if you would be eligible for a transplant.  A catheter is the worst option.  It is associated with complications including blood clots, poor dialysis, infection and mechanical failure of the catheter.  Hence, I would suggest that you continue to consult with a vascular surgeon about your options.  The goal is the best access that you can achieve.  In some cases, artificial veins can be used (grafts) for the fistula.  I suggest you discuss this with both your nephrologist and your vascular surgeon.

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