Experimental repair of venous valvular insufficiency using a cryopreserved venous valve allograft aided by a distal arteriovenous fistula

H. M. Burkhart, S. W. Fath, Michael Dalsing, Alan Sawchuk, D. F. Cikrit, S. G. Lalka

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: To evaluate the patency and hemodynamic impact of a cryopreserved allograft venous valve transplanted to the superficial femoral vein (SFV) of a canine insufficiency model aided by a distal arteriovenous fistula (dAVF). Methods: Eight greyhounds had intravenous hemodynamic parameters measured (venous falling time [VFT], 90% of venous refilling time [VRT90], and simulated ambulatory venous pressure [AVP]) before (T0) and after complete hindlimb venous valvulotomy (T1) to produce venous insufficiency. Simultaneously, a valve-containing veto segment was harvested from the opposite SFV or external jugular vein (n = 1) and cryopreserved. Three weeks later a blood type-matched cryopreserved valve was transplanted to the insufficient SFV aided by a low-flow (n = 4) or high-flow (n = 4) dAVF. The fistula was ligated in 3 to 6 weeks, and venous indexes (T2) were obtained 3 weeks later. Analysis of variances compared the venous indexes at T0, T1, and T2 for statistical significance. Gross and histologic inspection assessed valve integrity. Results: Two valves aided by a low-flow dAVF exhibited thrombosis and scarring. The hemodynamics of the six remaining valves demonstrated normalization of the VRT90, an AVP consistent with insufficiency, and a VFT between normal and total venous insufficiency. The patent valves were normal on gross examination and by histologic examination with signs of normal external healing. Conclusions: A cryopreserved venous valve allograft transplanted to the SFV of an incompetent hindlimb partially corrects venous hemodynamics. A high-flow arteriovenous fistula most consistently preserves transplant patency.

Original languageEnglish
Pages (from-to)817-822
Number of pages6
JournalJournal of Vascular Surgery
Volume26
Issue number5
StatePublished - 1997

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Venous Valves
Venous Insufficiency
Femoral Vein
Arteriovenous Fistula
Allografts
Hemodynamics
Venous Pressure
Hindlimb
Jugular Veins
Fistula
Cicatrix
Canidae
Analysis of Variance
Thrombosis
Transplants

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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Experimental repair of venous valvular insufficiency using a cryopreserved venous valve allograft aided by a distal arteriovenous fistula. / Burkhart, H. M.; Fath, S. W.; Dalsing, Michael; Sawchuk, Alan; Cikrit, D. F.; Lalka, S. G.

In: Journal of Vascular Surgery, Vol. 26, No. 5, 1997, p. 817-822.

Research output: Contribution to journalArticle

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