The Hemodialysis Reliable Outflow (HeRO®) Vascular Access Device is a novel long-term subcutaneous dialysis graft, ideally suited for catheter-dependent patients and patients dialyzing with failing fistulas or grafts due to venous outflow stenosis. This case presentation depicts the clinical course of the first patient to enter a Food and Drug Administration approved clinical trial and receive the HeRO device. The course of this patient over 56 months of follow-up provides the longest experience with the HeRO device to-date. In this patient, the HeRO device provided long-term dialysis access patency in conjunction with adequate dialysis and a low intervention rate.
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