What is a valve repair for venous disease?
In valve repair, the surgeon shortens the valves inside the vein to improve valve function.
Why is this procedure performed? Why do I need this procedure?
You may need this procedure if you have venous insufficiency, in which the flow of blood through the veins is impaired.
In healthy veins, there is continuous flow of blood from the limbs back toward the heart. There are valves within the veins of the legs that prevent the backflow of blood. Venous insufficiency occurs when forward flow through the veins is obstructed, as in the case of a blood clot, or if there is backward leakage of blood flow through damaged valves.
Valves can be damaged due to a trauma, like a blood clot. Other times, however, the valves just don't work right. They may have developed wrong, or they may have changed slowly over time — but there is no obvious underlying reason why they don't work. In those cases it is termed "primary" reflux (if it's after an injury like a deep vein thrombosis, then it is termed "secondary" reflux).
Valve repair or valve transposition is typically performed in individuals who have severe venous insufficiency associated with leg swelling and chronic ulceration that has been resistant to standard medical therapies.
Each patient is evaluated, and treatment will be individualized for the patient’s circumstances.
Where is the procedure performed and who performs this procedure?
Valve repair is performed in the hospital setting by a vascular surgeon.
What are the risks and potential complications of the procedure?
Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you.
Valve repair usually has no complications, but there may be a risk of injury to the blood vessel, leg swelling, bleeding, wound complications and, while rare, the development of a blood clot in the vein. Your vascular surgeon will discuss the important risks and benefits with you.
Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the procedure and why the procedure is recommended.
How do I prepare for the procedure?
A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the surgery. You may need to discontinue certain medications before the procedure. Your health care team will provide specific instructions to help you prepare for the procedure.
What happens during the procedure?
The procedure will be performed under general or epidural anesthesia. The surgeon accesses the affected vein through a small skin incision and folds or tucks the valve flaps of the vein to allow the valve edges to be beside each other. The surgeon may place a fabric sleeve around the outside of the affected vein to help prevent the vein from dilating beyond the point at which the valve edges would not be next to each other. The exact type of valve repair will be determined by your surgeon, and it will depend on the anatomy of your valves that require repair.
How long does the procedure last?
The procedure itself generally takes three to five hours, but the preparation and recovery time add several hours. The surgery may require a minimum hospital stay of four to seven days.
What happens after the procedure?
Some patients require admission to an intensive care unit for close monitoring for about one to two days after the surgery, but this is not routine. Once the patient is transferred to the nursing unit, the hospital stay is about three to seven more days.
Most patients will receive physical therapy during the recovery period. Most patients will require anti-coagulation treatment following the procedure, and this will be continued after hospital discharge. The duration of anti-coagulation treatment will be determined on an individual basis by your surgeon.
Your doctor will provide specific guidelines for your recovery.
Are there any side effects of the treatment?
As with any surgical procedure, you will feel somewhat tired for a few weeks. You will have mild pain along the incisions, and you may experience mild leg swelling.
What are typical results of the procedure?
Restoring blood flow by performing valve repair usually provides good relief of symptoms in the right patients. Your doctor will discuss the results of the procedure with you.
How do I find out if I am a candidate for this procedure?
To find out if you are a candidate for this procedure, please call the Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 4-4508.