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Early results of using the bovine jugular vein for right ventricular outflow reconstruction during the Ross procedure.

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surgery, Adolescent, Adult, Animals, Cardiac Surgical Procedures, Cattle, Child, Child, Preschool, Female, Humans, Infant, Jugular Veins, physiology, transplantation, Male, Pulmonary Valve, Treatment Outcome, Ventricular Outflow Obstruction

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      Abstract

      To study the early function of the bovine jugular vein (BJV) when used for right ventricular outflow tract (RVOT) reconstruction during the Ross procedure. Seventeen consecutive patients (median age, 12 years; range, 30 days to 40 years) who had undergone a Ross procedure with RVOT reconstruction using a BJV were reviewed. Nine patients had prior balloon valvotomy (n = 6) and/or surgical aortic valvotomy (n = 4). Additional procedures included a reduction-plasty of the ascending aorta (5 patients), a Konno procedure (2 patients), a mitral valve repair/replacement (2 patients), and others (3 patients). The size of the BJV ranged from 12 to 22 mm (median, 20 mm). There were no early or late deaths. None of the patients encountered any significant postoperative complications. The neo-aortic valve showed good function in all patients with no more than trivial insufficiency. At a median follow-up period of 11 months, the frequency of freedom from BJV graft dysfunction/reintervention/reoperation was 100%. One patient had moderate insufficiency of the BJV in a perioperative examination that regressed to mild insufficiency during follow-up. Overall, none of the patients had more than mild insufficiency at follow-up. Four patients showed a flow acceleration of more than 250 cm/s (equivalent to a gradient of 25 mm Hg) across the BJV, and the remaining patients had lower gradients. The BJV, when used to replace the pulmonary valve in the Ross procedure, showed excellent function in the early phase. The large size range and easy availability of this valved conduit are particularly attractive. Further followup is needed to determine the long-term results of its use.

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      14721817

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