Surgical Intervention for Severe CVI: The SAVVE Trial at Yale

Transcript

• 00:05- Because we walk around, stand
• 00:07and to various activities standing during our regular daily lives.
• 00:12Gravity always tend to pull the blood to the lower extremity
• 00:15and the only reason why blood continues
• 00:18to go up to the heart against gravity is because of the valves in the veins
• 00:22and the valves in the veins promote the blood to go
• 00:26from the legs back to the heart.
• 00:29Valves are very important to maintain lower
• 00:33pressure in the system and allow one directional flow.
• 00:37But if they failed there's a two directional flow,
• 00:41which is abnormal flow back towards what came from.
• 00:48Chronic Venous Insufficiency is a very common condition.
• 00:52It affects a third of the adults in the United States.
• 01:06There's a variety of problems that can affect the venous system, that can cause Chronic Venous Insufficiency.
• 01:12Valve problems are one group of the physiological processes that affect patients with venous insufficiency,
• 01:19and we have a variety of treatment to treat superficial venous reflux,
• 01:23which is abnormal valves in the superficial veins.
• 01:27But so far we have not had any surgical treatment for deep valvular reflux.
• 01:35These patients have high blood pressure in their venous system,
• 01:38and so that can lead to skin problems, even ulcers
• 01:43and the worst case, they can have severe infections in these ulcers.
• 01:47They have constant pain in the leg, which is very uncomfortable,
• 01:51oftentimes to the point then they actually have to quit their jobs and become disabled.
• 02:02The SAVVE Trial, SAVVE is an acronym for Surgical Antireflux Venous Valve Endoprosthesis
• 02:09SAVVE basically brings a totally novel treatment to deep valvular disease.
• 02:16It allows us to implant a bioprosthesis.
• 02:20It's a metal frame that contains
• 02:24a surgically sutured, porcine cardiac valve on it,
• 02:29and basically it helps the blood flow to go back up when it's implanted in this position
• 02:34and when the blood tries to go down back to the legs
• 02:37because of gravity, that valve opens up and halts it.
• 02:41And with this happening, there's less blood reflux
• 02:45back to the legs and staying in the legs.
• 02:50The procedure is relatively simple.
• 02:52It does involve an incision in the middle of the thigh where we expose the femoral vein
• 02:57and then the valve is surgically implanted into the vein.
• 03:01By that I mean that there's a small incision made in the vein.
• 03:04The valve is implanted and then sutured in place and then the incision is closed
• 03:09and the patient recovers for probably about 1 to 2 days,
• 03:12hopefully one day in the hospital before going home.
• 03:19Gravity is really your enemy in that disease.
• 03:22The SAVVE Trial brings in totally new and a game changer
• 03:27for patients with deep venous incompetence and valvular problems.
• 03:32Our hope is that we can actually
• 03:35get the patient almost to a cure
• 03:38so that they no longer have to contend with the high venous pressure
• 03:41as you see in chronic venous insufficiency.
• 03:44If you have wounds in the leg, you have swelling, physical for evaluation,
• 03:51you may be a candidate and it
• 03:52really will improve the quality of life.
• 03:57We're able to help you as a patient to fight the gravity
• 04:01and get your blood going back to the heart as it should normally go.