R. Tripathi et Kd. Ktenidis, Trapdoor internal valvuloplasty - A new technique for primary deep vein valvular incompetence, EUR J VAS E, 22(1), 2001, pp. 86-89
Citations number
11
Categorie Soggetti
Surgery
Journal title
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Objectives: to describe a new technique of exposure of the valve commissure
, called the "Trapdoor" Internal Valvuloplasty (TIV), to treat primary deep
vein valvular incompetence.
Material and Methods: the TIV method involves partial transverse incisions
which are joined together by a vertical incision to create a virtual "trapd
oor" at the target vein valve, providing optimum access to repair the insuf
ficient valve. In 17 consecutive patients (25 limbs) TIV has been successfu
lly employed for 41 valvular repairs since August 1999. All patients had op
en non-healing or recurrent venous ulcers.
Results: on mean follow-up of six months (clinical assessment of venous ulc
er healing and by colour-coded Duplex scans at 1, 3, 6, 9 and 12 months), o
f the 41 valves repaired by TIV technique, 39 valves (95%) maintained full
patency. Thirty-four valves (85%) achieved primarily a VCT <0.5 s without r
eflux at the target valves on Valsalva manoeuvre in the upright position. E
ighty-four percent of all ulcers (n = 25) healed within 8 weeks of surgery
without recurrence during the follow-up period.
Conclusion: the Trapdoor Internal Valvuloplasty (TIV) represents a novel te
chnique, which has the advantages of being both technically less demanding
and anatomically better defined. furthermore, TIV is physiologically accept
able and enables accurate localisation of valve cusp defects while allowing
comprehensive, anatomical repair of valvular deficiencies.