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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 Open the ORCID record for Parth M. Patel [Opens in a new window] ,
Jeremy L. Herrmann ,
Mark D. Rodefeld ,
Mark W. Turrentine  and
John W. Brown
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: [email protected]
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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.

Keywords

Bovine jugular vein conduitpulmonary homograftRoss operation
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 3 , March 2020 , pp. 323 - 327
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

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