Fig. 1

(A) The anterior valve of the SFV had almost disappeared, the posterior valve was rigid and thickened. (B) The AV was anastomosed with the FV end to side and the SFV ligated. (C) The transplanted AV valve segment was covered with the patch. (D) The arrow shows the lengthy posterior valve of the first pair of valves of the SFV during surgery. The anterior valve had almost disappeared and could not be shown in images. (E) The long arrow refers to the ligated SFV. The short arrow refers to the healthy valve area of the shunt AV, which completely blocked proximal blood flow (strip test). (F) The arrow shows the sleeve wrapping (SW) for the AV valve. Abbrevation CFV, Common femoral vein; SFV, Superficial femoral vein; GSV, Great saphaneous vein; AV, Axillary vein; SW, Sleeve wrapping