Percutaneous autologous venous valve transplantation: Short-term feasibility study in an ovine model Dusan Pavcnik, MD, PhD, Qiang Yin, MD, Barry Uchida,

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Percutaneous autologous venous valve transplantation: Short-term feasibility study in an ovine model Dusan Pavcnik, MD, PhD, Qiang Yin, MD, Barry Uchida, BS, Won Kyu Park, MD, Hanno Hoppe, MD, Man Duck Kim, MD, Frederick S. Keller, MD, Josef Rösch, MD Journal of Vascular Surgery Volume 46, Issue 2, Pages 338-345 (August 2007) DOI: 10.1016/j.jvs.2007.04.060 Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 1 Stent valve template (SVT) 15 mm in diameter with four barbs and four markers (arrows). Journal of Vascular Surgery 2007 46, 338-345DOI: (10.1016/j.jvs.2007.04.060) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 2 Autologous venous valve attached to a stent valve template a, Distended vein segment with a bicuspid valve (arrow). White arrow demonstrates direction of the blood flow. b, Distended vein segment placed inside the stent valve template. The apex of each commissure is sutured to the tip of the square stent bend (arrow). c, Completed autologous venous valve attached to a stent valve template. Arrows demonstrate valve commissures. Journal of Vascular Surgery 2007 46, 338-345DOI: (10.1016/j.jvs.2007.04.060) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 3 Venogram of the autologous venous valve transplant at 3 months. a, Ascending jugular venogram in lateral view demonstrates patency of the transplanted valve (arrows). b, Descending jugular venogram in lateral view demonstrates competency of the transplanted valve (arrows). c, Ascending venogram in anterior posterior view shows sinus formation at the stent valve template (arrows). Journal of Vascular Surgery 2007 46, 338-345DOI: (10.1016/j.jvs.2007.04.060) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 4 Venoscopy of the transplanted valve at 3 months. a, Bicuspid valve inside a flow model demonstrates thin leaflets in open position and (b) closed position. c, Specimen of the transplanted valve shows incorporation of the bicuspid valve into the host vein. Journal of Vascular Surgery 2007 46, 338-345DOI: (10.1016/j.jvs.2007.04.060) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 5 Hematoxylin and eosin stain of transplanted bicuspid valve at 3 months. a, Longitudinal microscopic view of both transplanted leaflets. Arrow points to native valve inside the SVT created sinus above incompletely incorporated edge of autologous valve vein wall into the host vein. b, Magnified view (50x). Journal of Vascular Surgery 2007 46, 338-345DOI: (10.1016/j.jvs.2007.04.060) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions