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January 1987

A Simple Intraoperative Assessment of Saphenous Vein Arterial Grafts

Author Affiliations

Andover, Mass

Arch Surg. 1987;122(1):121. doi:10.1001/archsurg.1987.01400130127029

To the Editor.—I should like to make a few comments on the article by Bandyk and colleagues1 in the March issue of the Archives. While I have no quarrel with the elegant intraoperative studies done by Bandyk and associates, I feel that pulsed Doppler spectral analysis may not be available to the average community hospital surgeon, and I feel it is redundant if proper attention is given to the techniques of this procedure. We perform our operation with a modified Hall valvulotome and have recognized no residual or retained valves during surgery or in the early postoperative period in 61 consecutive cases. Our patients are followed up at three-month intervals, and we did recognize a hypertrophied valve causing hemodynamic disturbances at the one-year mark in one patient. Indeed, this hypertrophied valve was detected with a simple bidirectional Doppler transducer and was explored and excised, and the graft was