A Compliant Dynamic Arteriovenous Fistula
The Design and Validation of a Robust Implantable Valve
D.W. Ulijn (TU Delft - Mechanical Engineering)
J.L. Herder – Mentor (TU Delft - Precision and Microsystems Engineering)
T. Horeman-Franse – Mentor (TU Delft - Medical Instruments & Bio-Inspired Technology)
N.A. White – Mentor (TU Delft - Medical Instruments & Bio-Inspired Technology)
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Abstract
Each year in the Netherlands almost two thousand people are diagnosed with End Stage Kidney Disease, amounting to a total of 7 million people worldwide. With an insufficient amount of donors available, most of these patients are treated using haemodialysis where the blood is filtered with a dialysis machine. Prior to this treatment an arteriovenous fistula (AVF) or arteriovenous graft(AVG) is created to increase their blood flow sufficiently to speed up the filtration process. Another result of increasing the blood flow is the size increase of the vein, leading to easier access. Unfortunately, the continuous high flow rate is linked to various negative effects. To counter these negative effects a Dynamic Arteriovenous System (DAS) or dynamic AVF (dAVF) was developed that can regulate the flow on demand. This allows for the flow to be increased temporarily during dialysis and to return to nominal values outside of dialysis with the ultimate goal of increasing life expectancy. Earlier iterations of the dAVF encountered reliability issues due to the formation of fibrous tissue on critical locations of the implant hindering actuation on the anastomosis. For this project, a compliant implantable dAVF-Valve is developed that minimizes the influence of ingrowth and provides a more robust solution.