OBJECTIVE: The HeRO graft is a technique for vascular access in patients with limited treatment options; however, the published results with the HeRO graft are diverging. We therefore conducted a single-center study.
METHODS: Patient records between July 2014 and February 2020 from Vascular Access Unit of the Department of Vascular and Endovascular Surgery of University Clinic of Cologne (Germany) were reviewed. Retrospective data was analysed from patients with a HeRo graft (n = 18).
RESULTS: Eighteen patients were enrolled in the study. The mean age of the patients was 62.8 ± 17.24 years. During the follow-up period, no patients died from complications related to the HeRO graft. Each patient had a mean of 1.94 concomitant diseases. The primary patency rates of the HeRO graft at 3, 6, 12, 18, and 24 months were 61.1%, 50%, 16.7%, 11.1%, and 5.6%, respectively. The secondary patency rates at the same time intervals were 77.8%, 72.8%, 55.6% 55.6%, and 55.6%, respectively. There were 44 re-operations per year, or 2.4 operations per patient. The main cause of acute complications was acute graft occlusions after HERO graft implantation. An infection after the graft implantation occurred in five (27.7%) patients, leading to graft explanation in 2 cases.
CONCLUSIONS: The use of the HERO graft is a valuable alternative method for providing a durable dialysis access in patients with limited access options. The secondary patency and survival are good with a low infection rate.

Patients requiring chronic dialysis are at increased risk for a severe complication such as Infective Endocarditis (IE). Infections, immediately after cardiovascular diseases, are the second leading cause of deaths in this group of patients. In the Polish population, the incidence of IE in hemodialysis patients is unknown.
OBJECTIVE: The aim of the study was to present epidemiology, clinical and echocardiographic characteristics and microbiological profile of infective endocarditis with the evaluation of the suitability of the modified Duke criteria for the diagnosis of IE in hemodialysis patients.
METHODS: The aim of the study was to present epidemiology, clinical and echocardiographic characteristics and microbiological profile of infective endocarditis with the evaluation of the suitability of the modified Duke criteria for the diagnosis of IE in hemodialysis patients.
RESULTS: Ten cases of IE in HD patients were diagnosed. The incidence of IE was 1.55/10,000 dialysis sessions/year. The incidence rate for IE in the dialysis population was 2,000/100,000 patients/year, while the incidence rate for IE in all hospitalized individuals was 5/100,000 patients/year. Hemodialyzed patients had significantly higher odds of having IE compared to other hospitalized individuals (odds ratio [OR] = 69; 95%; CI: 35.92-132.06,p<0.0001). Mitral valve involvement was the most frequent. The most common IE etiology was Staphylococcus species. Based on the modified Duke criteria, the \"definite IE\" was recognized in one case whereas remaining 9 cases were classified as the \"possible IE\".
CONCLUSIONS: In hemodialyzed patients the risk of IE is approximately 69 times higher than in the general hospitalized population. Right heart valve involvement occurs seldom despite the presence of vascular catheters. The modified Duke criteria have a limited applicability in the diagnosis of infective endocarditis.