• J. Thorac. Cardiovasc. Surg. · Sep 2022

    Comparison of homografts and bovine jugular vein conduits in the pulmonary position in patients <20 years of age.

    • Supreet P Marathe, Nadia Hussein, Fraser R O Wallace, Douglas Bell, Matthew Yong, Kim S Betts, Cameron Ward, Homayoun Jalali, Prem Venugopal, Igor E Konstantinov, and Nelson Alphonso.
    • Queensland Children's Hospital, Brisbane, Australia; School of Clinical Medicine, Children's Health Queensland Clinical Unit, University of Queensland, Brisbane, Australia; Child Health Research Centre, University of Queensland, Brisbane, Australia.
    • J. Thorac. Cardiovasc. Surg. 2022 Sep 1; 164 (3): 752-762.e8.

    ObjectiveTo compare the performance of homografts and bovine jugular vein (BJV) conduits in the pulmonary position.MethodsAll patients with congenital heart disease up to age 20 years who underwent pulmonary valve replacement with homografts or BJV at 3 centers in Australia were evaluated. There were 674 conduits, with 305 (45%) pulmonary homografts (PHs), 303 (45%) BJV conduits, and 66 (10%) aortic homografts (AHs). Endpoints were freedom from reintervention, structural valve degeneration (SVD), and infective endocarditis (IE). Propensity score matching was used to balance the comparison of PH and BJV conduits.ResultsThe median follow-up was 6.4 years (interquartile range, IQR, 3.1-10.7 years). Freedom from reintervention at 5 and 10 years was 92% and 80%, respectively, for PH, 74% and 37% for BJV, and 75% and 47% for AH. BJV conduits had a higher risk of reintervention (P < .001) and SVD (P < .001) compared with PHs. These findings were confirmed with propensity score matching valid for conduit size >15 mm. AHs >15 mm had a higher risk of reintervention (P < .001) and SVD (P < .001) compared with PHs >15 mm. The performance of AHs and BJV conduits was similar across all sizes (reintervention, P = .94; SVD, P = .72). The incidence of IE was 1% for PH, 10% for BJV, and 1.5% for AH.ConclusionsIn patients age <20 years with a conduit >15 mm, PHs outperformed BJV conduits and AHs in the pulmonary position. The performance of AH and BJV was comparable. Small conduits (≤15 mm) had similar performance across all conduit types.Crown Copyright © 2021. Published by Elsevier Inc. All rights reserved.

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