Bovine Jugular Vein Conduit: A Mid- to Long-Term Institutional Review

Patel, Parth M.; Tan, Corinne W.; Srivastava, Nayan T.; Herrmann, Jeremy L.; Rodefeld, Mark D.; Turrentine, Mark W.; Brown, John W.

doi:10.1177/2150135118779356

Cited by 30 publications

(55 citation statements)

References 22 publications

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“…[2][3][4] We routinely oversized the right ventricle to pulmonary artery conduit during the Ross operations since we found the smaller conduit size to be an independent risk factor in the right ventricle to pulmonary artery conduit replacement across all etiologies of initial right ventricular outflow tract surgery. 17,18 Horer et al showed this specifically in the Ross population. 19 Whether oversizing the right ventricle to pulmonary artery conduit leads to increased freedom from replacement is debated in literature.…”

Section: Discussionmentioning

confidence: 92%

“…[21][22][23] We have observed an incidence of bovine jugular vein conduit endocarditis at our institution of approximately 7%, and half of these patients have been successfully treated with antibiotics alone. 18 Beckerman et al in their study noted a 10% incidence of endocarditis with 92% of those patients requiring surgical intervention. 22 Zimmerman et al found that the use of bovine jugular vein was an independent risk factor for right-sided reoperation after the Ross operation.…”

Section: Discussionmentioning

confidence: 94%

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Bovine jugular vein conduit versus pulmonary homograft in the Ross operation

et al. 2019

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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.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 94%

Bovine jugular vein conduit versus pulmonary homograft in the Ross operation

et al. 2019

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“…However, it was only moderate and could not be the main cause of conduit failure, as reported for bovine jugular vein grafts and homografts. 5,26,30 In the DE-PVC group, proximal stenosis of the xenograft due to calcification of the walls and leaflets was the most typical. In the GA-PVC group, distal stenosis occurred more often and caused by neointimal proliferation.…”

Section: Commentmentioning

confidence: 99%

“…The vast majority of xenografts used for RVOT reconstruction are GA-treated conduits. [1][2][3][4][5] However, according to experimental and clinical data, treatment with GA has its disadvantages, such as increased stiffness of the tissue, cytotoxicity, quick calcification, predisposition to neointimal proliferation, and thrombosis. 6,12,[20][21][22][23] From the 1970s, active search for new options in biomaterials treatment was initiated, which was aimed at decreasing or eliminating the negative effects of GA on the conduit tissue.…”

Section: Commentmentioning

confidence: 99%

“…The majority of xenografts used in RVOT surgery are treated with glutaraldehyde (GA). [1][2][3][4][5] However, some experimental studies showed benefits of biomaterial cross-linking with epoxy compounds as well. Epoxy compounds provide better resistance to calcification in comparison with GA. [6][7][8] Other advantages of epoxy compounds include less immunogenicity and cytotoxicity, as well as less negative effects on the mechanical properties of tissues.…”

Section: Introductionmentioning

confidence: 99%

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Diepoxy- Versus Glutaraldehyde-Treated Xenografts: Outcomes of Right Ventricular Outflow Tract Reconstruction in Children

Nichay

Zhuravleva

Kulyabin

et al. 2019

World J Pediatr Congenit Heart Surg

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Background: Xenografts used for right ventricular outflow tract (RVOT) reconstruction are typically treated with glutaraldehyde. However, potential benefit of epoxy treatment was demonstrated in experimental studies. We aimed to compare diepoxy-treated bovine pericardial valved conduits (DE-PVCs) and glutaraldehyde-treated bovine pericardial valved conduits (GA-PVCs) for RVOT reconstruction in pediatric patients. Methods: Between 2002 and 2017, 117 patients underwent RVOT reconstruction with PVC in single center: DE-PVC group, n = 39; and GA-PVC group, n = 78. After performing propensity score analysis (1:1) for the entire sample, 29 patients from the DE-PVC group were matched with 29 patients from the GA-PVC group. Results: There were no conduit-related deaths. In the DE-PVC group, the freedom from conduit failure was 90.9% at four years and 54.3% at eight years postoperatively. In the GA-PVC group, it was 46.3% and 33.1%, respectively. The difference was significant ( P = .037). Conduit failure was typically caused by stenosis in both groups. In the DE-PVC group, the main cause of stenosis was xenograft calcification (27.6%); while in the GA-PVC group, it was mostly due to neointimal proliferation (25.0%) and, less often, calcification (14.3%). Conduit thrombosis was the cause of replacement in 6.9% of patients from the GA-PVC group. Conclusions: Diepoxy-treated bovine pericardial valved conduit is a suitable alternative to GA-PVC for RVOT reconstruction in pediatric patients. Diepoxy-treated bovine pericardial valved conduits may be less prone to conduit failure and more resistant to neointimal proliferation and conduit thrombosis than GA-PVCs.

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