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Cow vein used in transplantTOLEDO, Ohio -- Bud Filson is 70 now, but he's been in pain since he was 52. For 18 years, Filson had a growing ulcer near his right ankle that would not heal. It made simple pleasures like walking to the corner an ordeal. "My mother and I used to walk around the block and I'd say I'd get a half a block and I'd have to sit on people's front step and rest my leg until the pain was over with, and I'd take off walking again." The ulcer that was the source of Filson's troubles was a symptom of CVI, or Chronic Venous Insufficiency. A condition affecting 2.5 million people in the United States, it is most common among people under the age of 60. CVI can be hereditary or caused by blood clots in the leg. It develops when a valve in the femoral vein of the leg ceases to work properly. The femoral is a primary vein located in the upper leg near the groin. The valves in that vein work to regulate the flow of blood between the heart and the legs. "The veins themselves have no way of pushing the blood up towards the heart," explained vascular surgeon Dr. Andrew Seiwert. "That's all dependent on a series of valves in the calf and in the thighs that act like a bellows." When those valves fail, blood begins to collect in the lower part of the legs, causing ulcers like the one that brought Filson to tears and made him plead with his doctors. "A lot of times tears come to my eyes," he said. "I was about ready to tell 'em either to do something with it or cut it off. Either one of the two." Doctors at the Toledo Hospital's Jobst Vascular Center preformed a new procedure that replaces the weakened vein valve in Filson's right leg with the jugular vein of a cow. It was the first successful test of a new method of dealing with weakened veins. "The neck vein of a cow is very similar in size to the femoral vein," said Doctor Hugh Beebe, the center's director. The bovine valve becomes a better fit, Beebe explained, in patients whose veins have grown wider from the disease. In order to prevent human rejection of the bovine tissue, the cow's valve is pre-treated with drugs. Bovine valves have been used in pediatric heart procedures for years. Beebe said the experience helped doctors because the transplant technology was already understood. The valve replacement surgery takes about 90 minutes and requires patients to stay a minimum of two days in the hospital. The Jobst Center is one of the few sites performing this procedure -- others are the Scripps Clinic in San Diego, California, and Hospital Pavia in Puerto Rico. Researchers are finishing the first phase of tests on the procedure. The next step will be to increase the number of patients and the number of places where the surgery is performed. Doctors caution that the procedure is still several years away from widespread use. But they are already looking ahead to other applications of the technology. "What I see coming next," predicted Beebe, "is the attempt to insert these valves without any kind of operation, using catheters and a minimally invasive technique." He added that the success of such procedures makes it more likely that animals one day will be genetically altered and bred specifically for organs that can be used in human transplantation. For now, doctors in Toledo are content to hear Filson say that, after 18 years of pain, life gets better by the day. "You've had pain for so darn many years then all of a sudden you don't have any. It's a miracle." RELATED STORIES:
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