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Bovine jugular vein conduit versus pulmonary homograft in the Ross operation

Published online by Cambridge University Press:  18 December 2019

Parth M. Patel*
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
Jeremy L. Herrmann
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Indiana University School of Medicine, Indianapolis, IN, USA Riley Children’s Health, Indiana University Health, Indianapolis, IN, USA
Mark D. Rodefeld
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Indiana University School of Medicine, Indianapolis, IN, USA Riley Children’s Health, Indiana University Health, Indianapolis, IN, USA
Mark W. Turrentine
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Indiana University School of Medicine, Indianapolis, IN, USA Riley Children’s Health, Indiana University Health, Indianapolis, IN, USA
John W. Brown
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Indiana University School of Medicine, Indianapolis, IN, USA Riley Children’s Health, Indiana University Health, Indianapolis, IN, USA
*
Author for correspondence: P. M. Patel, MD, Department of Surgery, Division of Cardiothoracic Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN 46202, USA. Tel: (317) 507-29022; Fax: (317) 647-4364; E-mail: parth.mukund.patel@emory.edu

Abstract

Objectives:

The Ross procedure involves using the native pulmonary valve for aortic valve replacement then replacing the pulmonary valve with an allograft or xenograft. We aimed to compare our age-matched experience with the bovine jugular vein conduit and the pulmonary homograft for pulmonary valve replacement during the Ross procedure in children.

Methods:

Between 1998 and 2016, 15 patients <18 years of age underwent a Ross procedure using the bovine jugular vein conduit (Ross-Bovine Jugular Vein Conduit) at our institution. These patients were age-matched with 15 patients who had the Ross operation with a standard pulmonary homograft for right ventricular outflow tract reconstruction (Ross-Pulmonary Homograft). Paper and electronic medical records were retrospectively reviewed.

Results:

The median age of the Ross-Bovine Jugular Vein Conduit and Ross-Pulmonary Homograft patients were 4.8 years (interquartile range 1.1–6.6) and 3.3 years (interquartile 1.2–7.6), respectively (p = 0.6). The median follow-up time for the Ross-Bovine Jugular Vein Conduit and Ross-Pulmonary Homograft groups were 1.7 years (interquartile range 0.5–4.9) and 6.8 years (interquartile range 1.9–13.4), respectively (p = 0.03). Overall, 5-year survival, freedom from redo aortic valve replacement, and freedom from pulmonary valve replacement were similar between groups.

Conclusion:

The bovine jugular vein conduit and pulmonary homograft have favourable mid-term durability when used for right ventricular outflow tract reconstruction for the Ross operation. The bovine jugular vein conduit may be a suitable replacement for appropriately sized patients undergoing a Ross aortic valve replacement, though longer follow-up is needed.

Type
Original Article
Copyright
© Cambridge University Press 2019

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Footnotes

*

Poster presentation at the 6th Scientific Meeting of the World Society Pediatric and Congenital Heart Surgery and 18th International Symposium on Congenital Heart Disease Orlando, FL, USA, 24 July, 2018

References

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