Replacement of venous defects by venous autografts.

At the present time there are few indications for the repair or replacement of venous defects. As the scope of surgery grows, however, reconstitution of the vena cava and other major veins will require the availability of suitable graft material. There is, at present, no definitive answer as to which type of replacement is most desirable for venous reconstruction. Indications for venous reconstruction presumably will include circumstances in which the superior vena cava, the inferior vena cava above the renal veins, the superior mesenteric veins, the portal vein, or one or both renal veins are involved by tumor, trauma, thrombosis or postinflammatory obliteration. Other indications might include instances in which major venous shunts are required, as in the surgery of congenital anomalies of the heart and great vessels, or in portal to systemic shunting procedures. The present study was undertaken first to compare autogenous with homologous vein grafts, and secondly