Hemodynamic results of femoral vein valve repair

Our aim was to assess the hemodynamic and clinical responses associated wit h valve repair surgery in 37 patients with severe chronic venous insufficie ncy. Patients classified as C(4-6)E(P)A(SDP)P(R) (primary venous dysfunctio n with skin changes with reflux of superficial, deep and perforating veins) were submitted to a novel procedure combining the closed technique describ ed by Kistner with the Dacron sleeve technique described by Hallberg (mean follow-up = 24 months). A significant improvement in Valsalva test results (P < 0.0001), ambulatory pressure (P = 0.0099), venous refilling time (P < 0.0001), and reflux index (P < 0.0001) was observed. Postoperative reactive hyperemia and gradient tests confirmed absence of venous obstruction signs . On their last visit, 85.3% of the patients had no ulceration, and edema w as absent or minimal in over 90%. About 70% of the patients referred partia l or complete relief of pain in the affected limb. The combined surgical te chnique was effective to control venous reflux 24 months after the procedur e. A longer follow-up would be necessary to assess longterm results. (C) 20 01 The International Society for Cardiovascular Surgery. Published by Elsev ier Science Ltd. All rights reserved.