In vivo use of human umbilical vessels and the ductus venosus arantii.

Clinical use of umbilical vessels in the neonate is commonplace. In the adult, surgical reopening of the umbilical vein is feasible in the majority of patients, providing direct access to the portal circulation. Umbilical vein catheterization allows for portal manometry in the intact, unanesthetized state. Prolonged catheterization has served to facilitate physiologic and pharmacologic studies hitherto unavailable. Selective splanchnic catheterization with hepatoportography permits roentgenographic studies, important in the evaluation of patients with hepatobiliary diseases. Clinically, the umbilical vein has been used in the study of portal hemodynamics, portal decompression and hemofiltration, portal arterialization and in evaluating hepatic trauma. This method of access to the portal circulation has provided a route for study of the effects of drugs, hormones and other biologic materials on the portal circulation and for administration of antibiotics and other chemotherapeutic agents into the portal system. The procedure of umbilical vein catheterization is simple and repeated catheterization is possible. The ductus venosus, on the other hand, is not clinically usable and pertinent information has been reviewed. The ex vivo use of neonatal umbilical veins as vascular conduits is not included in this review.