A STUDY OF THE FEMORAL VEIN PROXIMAL VALVE FUNCTION AND THE INFLUENCE OF VIS A TERGO AND VIS A FRONTE FACTORS TO IT WORK
1Ryazan State Medical University named after academician I.P. Pavlov, Ryazan, Russian Federation
2Ryazan Regional Clinical Cardiological Dispensary, Ryazan, Russian Federation
Objective: A study of the femoral vein proximal valve function and the influence of vis a tergo and vis a fronte factors to it work.
Methods: The study has done on 22 volunteers at the age of 18-80 years without signs of chronic venous diseases. It was conducted a comparison of vein diameter on the level of the intercuspidal incisura in patients with the proximal valve work and the absence of it.
Results: It was fixed that the functions of the valves in 9 patients, and degree of lumen reduction of significant variation from 35.5% to 55.4%. Functioning of the valves was not detected in 7 patients, however the grade of vein diameter composed from 27% to 62.5%. In patients with presence of cycle functioning valves, it was strictly corresponded to the act of breathing – factor vis a fronte. The 6 patients were examined for the studying the influence of the phases of cardiac cycle to the valve functions, to whom were received the conservative treatment in the department of vascular surgery. Within 2-3 days the valve cycle was detected in all patients as a result of the conducted therapy; it was strictly correlated with breathing and was not synchronized with ECG. To exclude the factor of vis a fronte the examination was performed during breath hold. The functioning of the valves was detected in all patients and closure of the valves occurred strictly following the phase of ventricular systole displayed on ECG; that is not effect of direct factor vis a tergo – the kinetic energy of the blood flow in cardiac ejection but effect of its main part-potential energy of vascular wall deformation.
Conclusions: The main mechanism of venous outflow in lower limbs are calm – the direct factor of vis a tergo. The main mechanism of lower limbs are not enough in blood volume expansions in venous system, includes the additional mechanism of venous back out in the following way of vis a fronte, the arteriovenous pump.
Keywords: Functioning of vein valve, vis a tergo, vis a fronte.
- Vankov VN. Stroenie ven [Veins structure]. Moscow, RF: Meditsina; 1974. 200 p.
- Shval’b PG, Kalinin RE, Shanaev IN, Puchkova GA, Suchkov IA. Topografoanatomicheskie osobennosti perforantnykh ven goleni [Specific topographical and anatomical features of perforating veins of the lower leg]. Flebologiya (Phlebology). 2015;9(2):18-26.
- Sultanov DD, Gaibov AD, Kalmykov EL, Mallaev SH. Faktory riska razvitiya varikoznoy bolezni u sel’skikh zhiteley yuzhnogo regiona Tadzhikistana. Novosti khirurgii. 2012;20(4):48-51.
- Kalinin RE, Suchkov IA, Zherebyat’eva SR, Pshennikov AS. Operatsii na sosudakh [Vascular operations]. Pod red. RE. Kalinina. Moscow, RF: GeotarMedia; 2015. p. 7-18.
- Trushkov PV. Traktat o venoznom klapane [Treatise on venous valve]. Kirov, RF; 2006. 120 p.
- Shval’b PG. Patologiya venoznogo vozvrata iz nizhnikh konechnostey [Venous return pathology in lower extremities]. Ryazan’, RF: Tigel’; 2009. 152 p.
- Sultanov DD, Azizov AA, Avgonov UM. Nekotorye voprosy patogeneza khronicheskoy venoznoy nedostatochnosti pri posttromboticheskoy bolezni [Some questions of pathogenesis of chronic venous insufficiency during postthrombotic disease]. Avicenna Bulletin (Vestnik Avitsenny). 2010;42(1):134-43.
- Agapov AB, Suchkov IA, Ryabkov AN. Pryamye peroral’nye antikoagulyanty v lechenii patsientov s trombozom glubokikh ven nizhnikh konechnostey [Direct oral anticoagulants in patients with deep venous thrombosis of lower extremities]. Nauka molodykh – Eruditio Juvenium. 2016;(2):147-57.
- Usmanov NU, Sultanov DD, Tosheva ZO. Sovremennye printsipy lecheniya varikoznoy bolezni ven nizhnikh konechnostey. Zdravookhranenie Tadzhikistana. 2005;1(2):41-3.
- Lurie F, Kistner RL, Eklof B. The mechanism of venous valve closure in normal physiologic conditions. Journal of Vascular Surgery. 2002;35:713-7.
- Kalinin RE, Suchkov IA, Mnihovich MV, Novikov AN, Pshennikov AS, Zherebyat’eva SR. Endoteliotropnye effekty mikronizirovannoy ochishchennoy fraktsii flavonoidov pri razlichnykh eksperimental’nykh modelyakh venoznoy endotelial’noy disfunktsii [Endothelial effects of the micronized purified flavonoid fraction in various experimental models of venous endothelial dysfunction]. Flebologiya (Phlebology). 2014;8(4):29-36.
- Lurie F. Mechanism of venous valve closure and role of the valve in circulation: A new concept. Journal of Vascular Surgery. 2003;38:955-61.
- Rybakova MK, Alyokhin MN, Mit’kov VV. Prakticheskoe rukovodstvo po ul’trazvukovoy diagnostike. Ekhokardiografiya [Practical handbook on ultrasound diagnosis. Echocardiography]. Moscow, RF: Vidar; 2008. 512 p.
- Gryaznov SV, Shval’b AP. Voprosy perestroyki gemodinamiki pri arterial’noy i venoznoy patologii v eksperimente [Aspects of haemodynamics reorganization for arterial and venous pathology during experiment]. Aktual’nye voprosy klinicheskoy meditsiny: sbornik nauchnykh trudov, posvyashchyonnyy 80-letiyu professora P.G. Shval’ba. Ryazan’, RF: RIO RyazGMU; 2012. p. 39-45.
- Evtikhov RM. Klinicheskaya khirurgiya [Clinical surgery]. Moscow, RF: GEOTAR-Media; 2005. 864 p.
- Shmidt R, Tevs G. Fiziologiya cheloveka v 4 tomakh [Human physiology]. Moscow, RF: Mir; 1986. 288 p.
- Litvinenko LM. Sosudisto-nervnye kompleksy tela cheloveka [Human vascular and nervous systems]. Moscow, RF: ZAO «Biznes Olimp»; 2011. 304 p.
Kalinin Roman Evgenyevich, Doctor of Medical Sciences, Full Professor, Head at the Department of Cardiovascular Surgery, Vascular and Interventional Radiology, Operative Surgery and Topographic Anatomy at Ryazan State Medical University named after academician I.P. Pavlov
Suchkov Igor Aleksandrovich, Doctor of Medical Sciences, Associate Professor, Professor at the Department of Cardiovascular Surgery, Vascular And Interventional Radiology, Operative Surgery аnd Topographic Anatomy at Ryazan State Medical University named after academician I.P. Pavlov
Puchkova Galina Anatolyevna, medical doctor at the Department of Cardiovascular Surgery at «Ryazan Regional Clinical Cardiological Dispensary»
Pashchenko Vasiliy Mihaylovich, Doctor of Biological Sciences, Full Professor at the Department of Mathematics, Physics and Medical Informatics at Ryazan State Medical University named after academician I.P. Pavlov
Shanaev Ivan Nikolaevich, Candidate of Medical Sciences, medical doctor at the Department of Vascular Surgery at «Ryazan Regional Clinical Cardiological Dispensary»
Kamaev Aleksey Andreevich, candidate for a degree at the Department of Cardiovascular Surgery, Vascular And Interventional Radiology, Operative Surgery аnd Topographic Anatomy at Ryazan State Medical University named after academician I.P. Pavlov
Podyablonskaya Irina Apollonovna, Candidate of Medical Sciences, Associate Professor at the Department of Surgery, Obstetrics аnd Gynecology at Ryazan State Medical University named after academician I.P. Pavlov
Address for correspondence:
Suchkov Igor Aleksandrovich
Doctor of Medical Sciences, Associate Professor, Professor at at the Department of Cardiovascular Surgery, Vascular and Interventional Radiology, Operative Surgery and Topographic Anatomy at Ryazan State Medical University named after academician I.P. Pavlov
390026, Russian Federation, Ryazan, Vysokovoltnaya Street, 9.
Tel: (+7) 903 8362417