The effect of valvulotomy on the flow rate through the saphenous vein graft: Clinical implications Albert K. Chin, MD, David N. Mayer, BA, Robert K.

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Presentation transcript:

The effect of valvulotomy on the flow rate through the saphenous vein graft: Clinical implications Albert K. Chin, MD, David N. Mayer, BA, Robert K. Goldman, BA *, Joel A. Lerman, BA **, Cornelius Olcott, MD, Thomas J. Fogarty, MD Journal of Vascular Surgery Volume 8, Issue 3, Pages 316-320 (September 1988) DOI: 10.1016/0741-5214(88)90284-4 Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Schematic diagram depicts test fixtures for nonpulsatile and pulsatile vein flow studies. In nonpulsatile fixture, saline solution perfused the vein at a pressure of 90 mm Hg. In the pulsatile fixture, an S-shaped tube provided back-pressure of 20 mm Hg. Journal of Vascular Surgery 1988 8, 316-320DOI: (10.1016/0741-5214(88)90284-4) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Valvulotomes used for valve disruption in this study included valve scissors, retrograde Mills valvulotome, Leather valvulotome, and a fiber-optic valvulotome. Journal of Vascular Surgery 1988 8, 316-320DOI: (10.1016/0741-5214(88)90284-4) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Increased flow rates after valvulotomy. Top curve corresponds to flow rates after valvulotomy. Bottom curve corresponds to flow rates in valve-intact vein segments. Significant flow differences occur for vein diameters less than 2.5 mm. B, An enlarged graph of the inset of A. Error bars correspond to mean flow rate (±standard error of the mean). Journal of Vascular Surgery 1988 8, 316-320DOI: (10.1016/0741-5214(88)90284-4) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Measurement of the elliptic orifice of an intact valve. γ corresponds to the long axis, and X corresponds to the short axis of the elliptic valve orifice as viewed through a fiber-optic angioscope. Journal of Vascular Surgery 1988 8, 316-320DOI: (10.1016/0741-5214(88)90284-4) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Inverse relationship between percentage increase in flow rate vs degree of stenosis of valve site (valve orifice/vein cross-sectional area). If valve orifice is small compared with vein size, a significant change occurs in the flow rate after valvulotomy. Journal of Vascular Surgery 1988 8, 316-320DOI: (10.1016/0741-5214(88)90284-4) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions