Vein valve transplant.

The sequelae of deep vein thrombophlebitis, such as postphlebitic syndrome with or without ulcer, can be treated by direct surgery on the valve. The present surgical treatment of stasis ulcer includes removal of the incompetent communicating veins with excision of the ulcer and skin graft. If this operation is performed on patients who actually have deep venous incompetence, then a high incidence of reulceration and skin graft slough may be expected if there is no concommitant correction of deep venous incompetence. Experimental studies to restore venous valve function such as autogenous vein valve transplant, valvoplasty, homologous vein transplant, and synthetic valve procedures have been tried. It has been shown that with autogenous vein graft there are a lower incidence of thrombosis and a more effective restoration of valve competency than with other procedures. We operated on six patients utilizing an autogenous vein valve from the upper extremity to achieve hemodynamically functioning venous system of the lower extremity. Data on pre- and postoperative noninvasive evaluations and ascending and descending venography with the results of surgery will be discussed.