Use of bovine jugular vein to reconstruct the right ventricular outflow tract: early results.
OBJECTIVE
We evaluate early results of bovine jugular vein conduits in the pulmonary outflow.


METHODS
Between April 2000 and September 2001, 31 conduits were placed in the outflow of the right ventricle. Patients who received a conduit as a staged surgical procedure were excluded (n = 3). Implantation age ranged from 0 to 21 years (median, 3.4 years). Conduit diameter ranged from 12 to 20 mm (median, 14 mm). Transthoracic echocardiography was performed at discharge and 3 months after surgery. Patients with significant pulmonary regurgitation and/or stenosis underwent cardiac catheterization.


RESULTS
Four patients died during the follow-up period. Three deaths were unrelated to the conduit. One death was related to the complete thrombosis of the conduit. At 3 months evaluation, pulmonary valve regurgitation was absent or trivial in 19, mild in 2 and severe in 3 of 24 survivors. Four patients had nonfatal conduit-related complications. A transient thrombus formation within 1 leaflet was noted postoperatively in a patient with a moderate pulmonary regurgitation. Three patients required reoperation 3 to 5.8 months after the implantation for conduit failure (mean, 4.3 months). Cardiac catheterization before replacement revealed an aneurysmal dilation of the conduit below a severe stenosis of the pulmonary bifurcation due to important neointimal proliferation.


CONCLUSIONS
Early failure of bovine jugular vein valved conduits can occur because of exaggerated intimal proliferation or thrombotic process within the conduit. Because of these complications, close echocardiographic follow-up is mandatory during the first weeks after implantation.
Boudjemline
Younes
Y
Service de Cardiologie Pédiatrique, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75743 Paris Cedex 15, France. younes.boudjemline@nck.ap-hop-paris.fr
Bonnet
Damien
D
Massih
Tony Abdel
TA
Agnoletti
Gabriella
G
Iserin
Franck
F
Jaubert
Francis
F
Sidi
Daniel
D
Vouhé
Pascal
P
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D006348:Cardiac Surgical Procedures; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D007601:Jugular Veins / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D012086:Reoperation; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology; D014694:Ventricular Outflow Obstruction / Q000401:mortality / Q000601:surgery*; D017725:Ventricular Pressure / Q000502:physiology