Outcomes of Right Ventricular Outflow Tract Reconstruction in Children: Retrospective Comparison Between Bovine Jugular Vein and Expanded Polytetrafluoroethylene Conduits

Pediatr Cardiol. 2021 Jan;42(1):100-108. doi: 10.1007/s00246-020-02458-0. Epub 2020 Sep 23.

Abstract

Bovine jugular vein (BJV) and expanded polytetrafluoroethylene (ePTFE) conduits have been described as alternatives to the homograft for right ventricular outflow tract (RVOT) reconstruction. This study compared RVOT reconstructions using BJV and ePTFE conduits performed in a single institution. The valve functions and outcomes of patients aged < 18 years who underwent primary RVOT reconstruction with a BJV or ePTFE conduit between 2013 and 2017 were retrospectively investigated. 44 patients (20 and 24 with BJV and ePTFE conduits, respectively) met the inclusion criteria. The mean follow-up time was 4.5 ± 1.5 years. No significant differences in peak RVOT velocity (1.8 ± 0.9 m/s vs 2.1 ± 0.9 m/s, P = 0.27), branch pulmonary stenosis (P = 0.50), or pulmonary regurgitation (P = 0.44) were found between the BJV and ePTFE conduit groups, respectively. Aneurysmal dilatation of the conduit was observed in 25.0% of the patients in the BJV conduit group but not in the ePTFE conduit group (P = 0.011). All the cases with aneurysmal dilatation of the BJV conduit were complicated with branch pulmonary stenosis up to 3.0 m/s (P = 0.004). No conduit infections occurred during the follow-up period, and no significant difference in conduit replacement (20.0% vs 8.3%, P = 0.43) was found between the BJV and ePTFE conduit groups, respectively. The outcomes of the RVOT reconstructions with BJV and ePTFE conduits were clinically satisfactory. Aneurysmal dilatation was found in the BJV conduit cases, with branch pulmonary stenosis as the risk factor.

Keywords: Conduit; Pulmonary stenosis; Rastelli operation; Right ventricular outflow tract.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Animals
  • Bioprosthesis / adverse effects
  • Cattle
  • Child
  • Child, Preschool
  • Female
  • Heart Valve Prosthesis / adverse effects
  • Heart Valve Prosthesis Implantation / adverse effects
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis Implantation / methods
  • Heart Ventricles / surgery
  • Humans
  • Infant
  • Jugular Veins / transplantation*
  • Male
  • Plastic Surgery Procedures / methods*
  • Polytetrafluoroethylene / therapeutic use*
  • Prosthesis Design
  • Pulmonary Valve Insufficiency / epidemiology
  • Pulmonary Valve Stenosis / epidemiology
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Ventricular Outflow Obstruction / surgery*

Substances

  • Polytetrafluoroethylene