Early results of the bovine jugular vein graft used for reconstruction of the right ventricular outflow tract

Background. This study is an assessment of early results of bovine jugular vein grafts (BJV) used to reconstruct the right ventricular outflow tract. Methods. Ninety-three consecutive BJV implantations performed between May 2001 and August 2003 were included in this study. The median age was 7.2 years. Indications included various forms of tetralogy of Fallot and pulmonary atresia (56 patients), aortic valve disease requiring a Ross procedure (21 patients), truncus arteriosus (8 patients), d-transposition of the great arteries with ventricular septal defect and pulmonary stenosis (5 patients) and miscellaneous (3 patients). Additional plasty of the intrapericardial pulmonary arteries was performed in 41 patients. Follow-up was complete with a mean duration of 20.3 +/- 5.8 months. Results. There were 3 patients (3.2%) with early deaths and 2(2.2%) with late deaths, but none were related to the bovine jugular vein grafts. Twelve bovine jugular vein grafts needed reintervention; 11 were due to development of a stenotic membrane at the anastomosis site and one was due to somatic outgrowth of the child (10 conduit replacements and two balloon dilatations). Overall freedom from reintervention. was 91.6% and 83.5% at 12 and 24 months, respectively. Small size (less than or equal to14 mm) conduits show respective rates of 80.7% and 63.6%, whereas larger sizes were 98% and 96%, free from reintervention at 12 and 24 months. Conclusions. Bovine jugular vein grafts, when used for reconstruction of the right ventricular outflow tract, showed good early-term results. Attrition of small size bovine jugular vein grafts, due to development of a stenotic process at the anastomotic site needs to be closely observed. Longer follow-up is needed to allow a more definitive comparison with other established options. (C) 2005 by The Society of Thoracic Surgeons.