Surgical correction of chronic deep venous insufficiency by valvular transposition.

Twelve limbs in nine patients undergoing venous valve transposition in treatment of severe chronic deep venous insufficiency are the subject of this report. Hemodynamic measurements including venous pressure studies, photoplethysmography, directional venous Doppler assessment, and impedance plethysmography were done pre- and postoperatively in each case, as was ascending and descending venography. The surgical technique is described in detail and diagrams illustrate general features of the reconstruction. The results show that a functioning valve in the deep venous system of the lower extremity may reverse pre-operative pathophysiology. This preliminary view of the operation indicates that it may have great promise in the field of direct venous reconstruction.