Bovine jugular vein valved conduit: up to 10 years follow-up.

ABSTRACT

OBJECTIVE: The present study evaluated the mortality and conduit failure in bovine jugular vein (BJV) conduits. METHODS: Between October 1999 and February 2009, 193 patients (mean age, 6.7 ± 5.8 years; range, 5 days to 18 years; mean weight, 23.9 ± 21.0 kg; range, 2.4-105.4 kg) had been discharged after BJV implantation. The reason for BJV implantation was right ventricular outflow tract reconstruction in 117 conduit replacement in 44, and the Ross procedure in 32. The diameter of the BJV was 12 mm in 18 patients (9.3%), 14 mm in 16 (8.3%), 16 mm in 42 (21.7%), 18 mm in 37 (19.2%), 20 mm in 15 (7.8%), and 22 mm in 65 (33.7%). RESULTS: At a mean ± SD follow-up of 4.6 ± 2.3 y/patient (range, 8 months to 10 years), 5 late deaths (2.6%) had occurred, all unrelated to conduit failure. Conduit-related problems required an interventional procedure as the first treatment in 10 patients (5.2%) within a mean interval of 2.5 ± 1.4 years (range, 8 months to 5.3 years) or surgical revision in 5 patients (2.6%) after 2.1 ± 1.9 years (range, 19 days to 4.1 years). Late deaths occurred in 5.9% (2/34) of patients with a BJV size of 12 to 14 mm versus 1.9% (3/159) in patients with a size of 16 to 22 mm (P = NS). An interventional procedure or surgical revision was required in 29.4% (10/34) of patients with a BJV size of 12 to 14 mm versus 3.1% (5/159) in patients with a size of 16 to 22 mm (P < .0005). CONCLUSIONS: After 10 years of experience with the BJV, this conduit has remained a reliable alternative to pulmonary homografts with respect to survival and freedom from conduit failure. However, the incidence was greater and the presentation of conduit failure was earlier in patients with a smaller size BJV conduit (12-14 mm).