Ask Dr. Z

Should we also report the removal of the old grafts, or would this be included in 36832 since it was in the same area? "Once we had dissected out the Hero graft, and also dissected out the old graft that it was also in this area causing confusion for the technicians at the Dialysis Unit, we now brought an 8 mm PTFE graft on to the field and then tunneled medially between the 2 locations. We systemically heparinized the patient, clamped the patent graft and then opened it. We beveled both ends and created end-to-end anastomosis utilizing 6-0 Gore-Tex stitch. This was performed at both ends of the graft. We now released the clamps after flushing the system and they were rewarded with good flow through this. Now, we turned attention to resecting the previously placed grafts. The occluded graft was then removed utilizing electrocautery and blunt dissection. The stumps were oversewn. An additional graft was also noticed at this point and it was also removed utilizing electrocautery and blunt dissection. We copiously irrigated. We obtained hemostasis."