FLAP-VALVUL METHOD: A NEW SURGICAL THERAPEVTIC APPROACH ON CHRONIC VALVULAR VENOUS INSUFFICIENCY(IN VITRO STUDY)

Material and methods: Saphenous vein segments that harvested from the patients undergone aorta coronary bypass graft surgery were studied. in group 1 {n=20), vein segments that includes valvul was used. in group il (n=20), veins without valvul was taken and a flap-valvul was created from vessel wall to the lumen in the triple length of the lumen's diameter. 5 different stress conditions were created in vitro with order; pressures were measured and closure times of the valvuls were recorded. For each stress condition; while 140 mmHg-pressure was trying to keep fixed in the proxi­ mal side (P1), which is connected to the systemic circulation, some variations were done on the pressure of the dis­ tal side (P2).

Condition 1: Pulsatile hydrostatic pressure with 80/min-frequence was applied from the distal.
Condition 2: Continuous hydrostatic pressure was applied.
Condition 3: Continuous pressure on the distal was cut abruptly.
Condition 4: The strip test was applied.
Condition 5: Negative pressure was applied from the distal.

Results: it was found that the valvuls were closed with 4 mmHg gradient in group I and 8 mmHg gradient in group 11. it was assurned that this gradient is acceptable. The opening gradient was kept in continuous pressure too. in retrog­ rade flow, valvuls were completely closed without any backflow in the both groups.

According to these results, we found our described technique, flap-valvul method, effective in vitro conditions which make up the first step of our study.