Bovine jugular veins in the pulmonary position in adults -- 5 years' experience with 64 implantations.

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.

CONCLUSION

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.