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Venous Valve Function – Meaning & Disorders

Venous valve function refers to the role of venous valves in ensuring one-directional blood flow back to the heart and preventing backflow in the veins.

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Things worth knowing about "Venous valve function"

Venous valve function refers to the role of venous valves in ensuring one-directional blood flow back to the heart and preventing backflow in the veins.

What is Venous Valve Function?

Venous valves are small, pocket-shaped structures located inside veins. Their primary role is to ensure that blood flows in only one direction – towards the heart. Venous valve function is especially critical in the legs, where blood must travel upward against the force of gravity. Without properly functioning venous valves, blood would flow backwards and pool in the lower extremities.

Structure and Function of Venous Valves

Venous valves consist of two crescent-shaped leaflets (cusps) formed from the inner wall of the vein. They open when blood flows toward the heart and close when the flow slows or reversal pressure builds up. This mechanism prevents backflow (reflux) and supports venous return through:

The muscle pump of the legs (leg movement pushes blood upward)
Breathing (negative pressure changes in the chest cavity promote venous return)
The heartbeat as the driving force of circulation

Location of Venous Valves

Venous valves are found mainly in the deep and superficial veins of the legs. They are particularly numerous in the veins of the lower leg. In contrast, large veins such as the vena cava and veins of the trunk contain few or no valves.

Disorders of Venous Valve Function

When venous valves fail to close properly, this is referred to as valvular insufficiency (venous insufficiency). This leads to blood backflow and increased pressure within the veins. Potential consequences include:

Varicose veins: Enlargement and twisting of superficial veins
Edema: Fluid accumulation in the tissue, especially around the ankles and lower legs
Chronic venous insufficiency (CVI): Long-term damage to veins and surrounding tissue
Venous leg ulcer (Ulcus cruris venosum): Open wounds on the lower leg resulting from severe venous disease

Causes of Impaired Venous Valve Function

Impaired venous valve function can have several causes:

Genetic predisposition: A family history of venous problems is frequently observed
Prolonged standing or sitting: Increases venous pressure and strains the valves
Pregnancy: Hormonal changes and pressure on pelvic veins
Obesity: Raises intra-abdominal pressure
Deep vein thrombosis (DVT): Can permanently damage venous valves (post-thrombotic syndrome)
Aging: The connective tissue of the valves loses elasticity over time

Diagnosis

Venous valve function is typically assessed using duplex ultrasonography. This imaging technique allows the physician to visualize blood flow in the veins and detect any backflow (reflux). Additional diagnostic methods include phlebography (X-ray with contrast agent) and photoplethysmography.

Treatment and Prevention

Treatment depends on the severity of the dysfunction:

Compression stockings: Support blood flow and reduce venous pressure
Physical activity: Regular exercise activates the muscle pump
Leg elevation: Relieves the veins during periods of rest
Sclerotherapy: Injection of a chemical agent to close off varicose veins
Surgical procedures: Such as vein stripping, endovenous laser treatment, or thermal ablation
Venous valve transplantation: Used in rare cases of severe valvular insufficiency

References

Rabe, E. et al. (2020): S2k guidelines for the diagnosis and treatment of varicose veins. German Society of Phlebology. AWMF Guidelines Register No. 037/018.
Partsch, H. & Mortimer, P. (2015): Compression for leg wounds. British Journal of Dermatology, 173(2), 359–369.
Nicolaides, A.N. et al. (2018): Management of chronic venous disorders of the lower limbs. International Angiology, 37(3), 181–254.

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