Bovine jugular vein conduit versus pulmonary homograft in the Ross operation. (18th December 2019)

• Record Type: Journal Article
• Authors: Patel, Parth M.; Herrmann, Jeremy L.; Rodefeld, Mark D.; Turrentine, Mark W.; Brown, John W.
• Is Part Of: Cardiology in the young. Volume 30:Number 3(2020)
• Page Start: 323
• Page End: 327
• Publication Date: 2019-12-18
• Subjects: Bovine jugular vein conduit, -- pulmonary homograft, -- Ross operation; Pediatric cardiology -- Periodicals; 618.9212
• DOI: 10.1017/S1047951119003007
• Languages: English
• ISSNs: 1047-9511

Abstract

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.