Late objective assessment of venous value surgery.

To evaluate the contribution of an isolated femoral venous value to venous hemodynamics, ten patients (12 limbs) who had undergone femoral valve transposition without saphenous vein stripping or ligation of perforators were followed up for 12 to 18 months after surgery. Ascending and descending venography were performed to document anatomic patency. Dynamic venous pressures and venous refilling times were recorded to evaluate muscle pump function and cutaneous congestion, respectively. Signs of venous hypertension and the need for elastic support were noted. No patient attained normal venous pressure at any time after surgery. Normalization of venous refilling time was transient: nine of 12 limbs had reverted to preoperative abnormal levels at 12 to 18 months and all required elastic support. Femoral value reconstruction performed alone for venous stasis is not sufficient. In postthrombotic venous ulcer, incompetent calf perforators remain a central problem.