Hemodynamic evaluation of a bioprosthetic venous prosthesis

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Presentation transcript:

Hemodynamic evaluation of a bioprosthetic venous prosthesis Giacomo A. DeLaria, MD, Travis Phifer, MD, Jeff Roy, BS, Roger Tu, PhD, Kalathi Thyagarajan, PhD, R.C. Quijano, MD, PhD Journal of Vascular Surgery Volume 18, Issue 4, Pages 577-586 (October 1993) DOI: 10.1016/0741-5214(93)90067-V Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Diagram of venous valve flow tester. Oscillating pump mimics respiratory cycle. Height adjustments in both overflow tanks control hydrostatic pressure. Video camera is positioned to record valve leaflct motion. VCR, Video cassette recorder; VVFT, venous valve flow tester. Journal of Vascular Surgery 1993 18, 577-586DOI: (10.1016/0741-5214(93)90067-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Relationship of valve orifice area to venous flow. Orifice area for fixed tissue is significantly reduced at increasing flows. Journal of Vascular Surgery 1993 18, 577-586DOI: (10.1016/0741-5214(93)90067-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Effects of increasing pressure on diameter of fresh and fixed valve sinus expansion. Final luminal diameters are reduced for fixed tissue compared with fresh tissue. Journal of Vascular Surgery 1993 18, 577-586DOI: (10.1016/0741-5214(93)90067-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Examples of pressure fluctuations in venous valve tester to mimic respiratory pressure cycle. At full inspiration, pressure on outflow side of valve exceeds inflow pressure, valve closes, and flow stops. With expiration, pressure differential reverses, valve opens, and flow resumes. Journal of Vascular Surgery 1993 18, 577-586DOI: (10.1016/0741-5214(93)90067-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Opening and closing times of fresh and fixed bovine external jugular vein valves during test trials in flow tester. Both fresh and fixed values opened completely when transvalvular gradient exceeded 1 mm Hg. After tissue fixation, valve opening times were slightly reduced. Journal of Vascular Surgery 1993 18, 577-586DOI: (10.1016/0741-5214(93)90067-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Glutaraldehyde-fixed segment of bovine jugular vein, including one complete bileaflet valve, is sewn into Delrin stent and covered with Dacron sleeve. Perforations at either end accommodate suture anastomosis. Arrow indicates direction of flow. Journal of Vascular Surgery 1993 18, 577-586DOI: (10.1016/0741-5214(93)90067-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions