Detection of “functional” valves in reversed saphenous vein bypass grafts: Identification with duplex ultrasonography Michael J. Tullis, MD, Jean Primozich,

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Presentation transcript:

Detection of “functional” valves in reversed saphenous vein bypass grafts: Identification with duplex ultrasonography Michael J. Tullis, MD, Jean Primozich, BS, RVT, D.Eugene Strandness, MD Journal of Vascular Surgery Volume 25, Issue 3, Pages 522-527 (March 1997) DOI: 10.1016/S0741-5214(97)70263-5 Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Three separate FV. A, Doppler waveform of completely competent FV. Arrow indicates valve closure that is associated with audible “click.” B, FV with valve closure (single arrow) and moderate reflux (double arrow). C, FV with valve closure (single arrow) and marked reflux (double arrow). Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Three separate FV. A, Doppler waveform of completely competent FV. Arrow indicates valve closure that is associated with audible “click.” B, FV with valve closure (single arrow) and moderate reflux (double arrow). C, FV with valve closure (single arrow) and marked reflux (double arrow). Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Three separate FV. A, Doppler waveform of completely competent FV. Arrow indicates valve closure that is associated with audible “click.” B, FV with valve closure (single arrow) and moderate reflux (double arrow). C, FV with valve closure (single arrow) and marked reflux (double arrow). Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 A, B-mode image of FV in longitudinal plane, arrow indicates valve cusp. B, Same FV in transverse plane demonstrating both valve cusps. Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 A, B-mode image of FV in longitudinal plane, arrow indicates valve cusp. B, Same FV in transverse plane demonstrating both valve cusps. Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Baseline Doppler waveform of FV with moderate reflux. B, Same FV with distal blood pressure cuff at suprasystolic pressure. Note intensification of reflux. C, FV after cuff deflation (arrow) with subsequent reactive hyperemia and disappearance of reflux. D, Sixteen seconds after cuff deflation there is return of diastolic flow reversal and FV reflux (arrow). E, Return to baseline Doppler waveform. Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Baseline Doppler waveform of FV with moderate reflux. B, Same FV with distal blood pressure cuff at suprasystolic pressure. Note intensification of reflux. C, FV after cuff deflation (arrow) with subsequent reactive hyperemia and disappearance of reflux. D, Sixteen seconds after cuff deflation there is return of diastolic flow reversal and FV reflux (arrow). E, Return to baseline Doppler waveform. Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Baseline Doppler waveform of FV with moderate reflux. B, Same FV with distal blood pressure cuff at suprasystolic pressure. Note intensification of reflux. C, FV after cuff deflation (arrow) with subsequent reactive hyperemia and disappearance of reflux. D, Sixteen seconds after cuff deflation there is return of diastolic flow reversal and FV reflux (arrow). E, Return to baseline Doppler waveform. Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Baseline Doppler waveform of FV with moderate reflux. B, Same FV with distal blood pressure cuff at suprasystolic pressure. Note intensification of reflux. C, FV after cuff deflation (arrow) with subsequent reactive hyperemia and disappearance of reflux. D, Sixteen seconds after cuff deflation there is return of diastolic flow reversal and FV reflux (arrow). E, Return to baseline Doppler waveform. Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Baseline Doppler waveform of FV with moderate reflux. B, Same FV with distal blood pressure cuff at suprasystolic pressure. Note intensification of reflux. C, FV after cuff deflation (arrow) with subsequent reactive hyperemia and disappearance of reflux. D, Sixteen seconds after cuff deflation there is return of diastolic flow reversal and FV reflux (arrow). E, Return to baseline Doppler waveform. Journal of Vascular Surgery 1997 25, 522-527DOI: (10.1016/S0741-5214(97)70263-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions