Distribution of Saphenous Vein Valves and Its Pratical Importance

Abstract

ObjectiveAmong the veins used as a graft in myocardial revascularizations and ends, great saphenous vein is the most used. Knowing the presence and location of valves has great importance when evaluating the surgical anatomy of the great saphenous vein. Despite major surgical application and many works involving great saphenous vein, the number of valves present in it from the saphenous hiatus to the medial epicondyle of the femur is still described inaccurately. The objective of this study is to quantify the valves of the great saphenous vein from the saphenous hiatus to the medial epicondyle of the femur to determine the best portion of the great saphenous vein to perform revascularization surgeries.MethodsThis is a crosssectional observational study in which it was analyzed great saphenous vein extracted from 30 cadavers. It was measured the length of the veins; (diameter) at its proximal, middle and distal, quantifying the number of valves in each one and the total number of valves at the great saphenous vein.ResultsThe frequency of valves in the great saphenous vein taken from the medial epicondyle of the femur to the saphenous hiatus was 4.82, ranging between 2 and 9. Moreover, there is a significant difference in the number of valves in the proximal and distal relative to the average.Conclusionthe median and distal portions of the saphenous vein in the thigh, are the best options for the realization of bridges due to the fact that these portions have fewer valves which therefore would tend to decrease the risk of complications connected with the valves in these grafts.

Saphenous vein valve assessment utilizing upright CT to potentially improve graft assessment for bypass surgery

“…To identify the best portion of the SV as a conduit for bypass surgery, the number and position of valves in the SV were reviewed. A Brazilian study characterized 60 veins from 30 adult cadavers and reported that the average number of valves from the medial epicondyle of the femur to the saphenous hiatus were 4.77 and 4.87 on the left and right sides, respectively 25 . Similarly, a Japanese study of 26 SVs from 20 adult cadavers found 111 valves (average: 4.27) between the SF junction and the upper patellar margin compared to 63 (average: 2.42) valves between the upper patellar margin and the medial malleolus 26 ; they also reported that greatest number of valves were observed within 10 cm from the SF junction and between 35 and 45 cm from the SF junction.…”

Saphenous Vein Valves Assessment Utilizing Upright CT. -Potentially Improve the Graft Assessment for Bypass Surgery-

“…To identify the best portion of the SV as a conduit for bypass surgery, the number and position of valves in SV were reviewed. A Brazilian study characterized 60 veins from 30 adult cadavers and reported that the average number of the valves from the medial epicondyle of the femur to the saphenous hiatus were 4.77 and 4.87 on the left and right side, respectively 23 . Similarly a Japanese study of 26 SV from 20 adult cadavers found 111 valves (average: 4.27) between the SF junction and the upper patellar margin compared to 63 (average: 2.42) valves between the upper patellar margin and the medial malleolus 24 ; they also reported that the valves most valves were observed within 10 cm from the SF junction and between 35-45 cm from the SF junction.…”

A Brief Comment on Vasa Vasorum of Human Saphenous Vein: relevance for Coronary Artery Bypass Surgery

“…It should be pointed out that hSV has numerous valves irregularly distributed throughout the vein length [ 28 ] . According to Portugal et al [ 29 ] , the average number of valves in hSV (taken from the medial epicondyle of the femur to the saphenous hiatus) is around 4.77-4.87; with a range of two to nine valves being present, all of which were bicuspid. Within hSV valves, at the base of the valve sinus, is located a "bizarre" structure, the agger, comprised mainly of smooth muscle and elastin [ 20 , 30 , 31 ] .…”