The fate of the valves of autogenous vein grafts

Abstract

Autogenous vein graft is still the best and most widely used material as arterial substitute. However, the factors influencing the long term patency rate of vein grafts remain obscure. One of these may be related to the fate of the venous valve leaflets which may remain unaffected or become fibrotic and cause stenosis. Normal valves, although reversed, cause no loss of lumen diameter and may be harmless whilst fibrotic valves are implicated in early graft failure (Szilaggi et al., 1973; Mavor et al., 1975). This failure may be caused by turbulence around the valve cusps (McNamara et al., 1967). We report two cases of autogenous vein grafts, imaged by ultrasound, demonstrating firstly a non-mobile fibrotic valve and secondly a normal mobile valve, which was the site of turbulent flow.