Fundamental physiologic concepts of venous hemodynamics and systemic venous return

Abstract

Understanding the nominal venous anatomy and venous hemodynamics is the first and fundamental step in understanding the pathophysiology of venous disorders. Over the last two decades, significant effort has gone into improving the management of chronic venous disorders resulting in substantial improvement in the management of patients affected by venous insufficiency. Given the continuity of the venous system especially pertinent to the relationship between thoracic, abdominal, pelvic, and infrainguinal venous anatomy, combined with the increasing knowledge we gained regarding hemodynamics of the venous system it is imperative that a comprehensive approach to venous disorders is undertaken that evaluates venous system as a continuum rather than an approach that would evaluate only isolated venous territory affected by a specific venous disorder. Understanding of venous anatomy and physiology, as the basic components for venous hemodynamics, is an essential step to gain insights into venous return concepts, initially described by Dr. Guyton. Dr. Guyton's model represents a fundamental and one of the most significant advancements in our understanding of venous return. This manuscript details essential domains of hemodynamics, which can be useful for validation of our current understanding of systemic venous return.