Venous Valve Transplantation in Postphlebitic and Postthrombotic Veins

Abstract

THE sequelae of deep venous insufficiency are well known and generally are attributed to ambulatory venous hypertension due to valvular incompetence. Destruction of valves occurs with recanalization after clotting within the deep venous system. Despite adequate venous channels for blood flow and an intact venous "muscle pump," venous return is greatly impaired whenever there is dependency of the lower limbs. Restoration of valvular function might be achieved by transplantation of valve-bearing segments, by creation of artificial valves using autogenous tissue or by the insertion of appropriate nonthrombogenic synthetic valves. Previously, autotransplantation of venous valves in healthy canine veins was carried out with patency consistently demonstrated by a single postoperative venogram. In many of the experiments, the venograms were done more than two months after operation and temporary occlusive thrombosis with early recanalization cannot be excluded. However, the valves were judged competent at surgical exposure six to 12 months after operation