title: Bovine jugular veins in the pulmonary position in adults -- 5 years' experience with 64 implantations.
abstract: OBJECTIVE
  The midterm durability of bovine jugular veins (BJV) in children is comparable to that of homografts. We present the results of 64 bovine jugular vein implantations in adults in a pulmonary position.
  
  
  METHODS
  Between August 2003 and July 2008, 60 patients (aged 18 to 65 years) received 64 BJVs. 97 % of them had had previous reconstructions of the right ventricular outflow tract. Diagnoses for treatment included tetralogy of Fallot (n = 49 patients), other congenital malformations (n = 14), and Ross operation (n = 1). Four bovine jugular veins had a diameter of 20 mm, the others had a diameter of 22 mm.
  
  
  RESULTS
  Survival after 5 years was 98.4 +/- 1.6 %. Freedom from endocarditis: 84.8 +/- 8.0 % (4 patients required explantation for endocarditis); freedom from explantation for structural valve degeneration: 96.2 +/- 2.6 % (2 patients required explantation); freedom from intervention: 93.2 +/- 2.8 % (3 patients required intervention); moderate insufficiency: 62.9 +/- 15.1 % (8 patients); gradient > or = 50 mmHg: 79.6 +/- 7.4 % (7 patients); degeneration: 56.4 +/- 12.9 % (11); any adverse event: 43.1 +/- 12.8 % (15 patients); calcification or aneurysmal dilatation: 100 %. At any postoperative interval, more than 75 % of the BJVs had neither been explanted nor were they degenerated.
  
  
  CONCLUSIONS
  The BJV might be a promising alternative to homografts, also in adults. Strict antibiotic prophylaxis is mandatory. A prospective randomized multicenter comparison of homografts and BJVs would help to identify the preferable conduit.
authors: Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany. boethig.dietmar@mh-hannover.de
authors: D
authors: D
authors: Boethig
authors: M
authors: M
authors: Westhoff-Bleck
authors: H
authors: H
authors: Hecker
authors: M
authors: M
authors: Ono
authors: A
authors: A
authors: Goerler
authors: S
authors: S
authors: Sarikouch
authors: T
authors: T
authors: Breymann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002404:Catheterization; D002417:Cattle; D004696:Endocarditis / Q000382:microbiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007601:Jugular Veins / Q000637:transplantation*; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D012086:Reoperation; D013203:Staphylococcal Infections; D016019:Survival Analysis; D014183:Transplantation, Heterologous / Q000009:adverse effects / Q000379:methods; D014694:Ventricular Outflow Obstruction / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D055815:Young Adult