I am sorry you are going through this as well. I have dialysis experience and will answer your questions to the best of my knowledge:
-Yes, you will need some form of dialysis, always, if you don't get a transplant.
-Yes, you can live a long time on dialysis. - There are alot of factors involved in how well you do on dialysis, including your health history. If you try, as best you can to continue taking any medications rxed, following the guidelines and diet suggestions given, this will promote a better dialysis experience. It is alot to learn at first, so take it one step at a time.
-There are alot of dialysis choices these days:
-Hemodialysis, home hemodialysis, nocturnal hemodialysis (night-time).
-As was mentioned, also, peritoneal dialysis, CCPD (Continuous Cyclic Peritoneal Dialysis - This is done while you sleep, so you don't need to do "exchanges" during the day.
-Regarding peritoneal dialysis (PD). PD is not necessarily hard to do. A PD nurse would spend several days with you training and would be in constant contact with you, for any questions. Infections can happen (peritonitis) but varies a great deal from person to person. Some people go yrs without peritonitis. These infections are usually cleared easily with antibiotics. - You might want to ask the doc. re a consult with a PD nurse, if interested.
-Regarding the shunt placement, to my knowledge this is an outpt surgery.
The shunt does not stick out from your arm. If you do hemodialysis, they will make sure to put numbing on your arm to make you comfortable. During hemo, the nurse or pt care tech, will constantly moniter you and do everything to make you comfortable and watch for side effects. It is actually better to put a shunt or fistula in ahead of time to allow the shunt site or fistula to "heal" in preparation for dialyisis.
-Whether you do PD or hemo, you will have access to a team: doctor, your nurse or tech, dietitian and a social worker. It IS very scary and confusing at first and it is only natural to be afraid, but I think as you gain more knowledge, you will feel a little more comfortable.
-Regarding a transplant, it is my guess that they don't necessarily think you are "unhealthy" but that with the heart bypass and valve problems, they would want to make sure you could withstand transplant surgery.
Best of luck to you. - It will get better, in time.