Comparison of bovine jugular vein conduits and polytetrafluoroethylene valved conduits for right ventricular outflow tract reconstruction.

Abstract

To compare the clinical outcomes of right ventricular outflow tract (RVOT) reconstruction using bovine jugular vein (BJV) conduits and polytetrafluoroethylene (PTFE) valved conduits. Patients who underwent RVOT reconstruction with BJV (Group C) or PTFE (Group P) conduits between 2013 and 2023 were reviewed retrospectively. The median duration of follow-up was 52.3 months. Conduit dysfunction was defined as a peak velocity ≥3.5 m/s or moderate or greater regurgitation. Excessive conduit dilation was defined as a >50% increase in diameter. Propensity score matching was performed. Predictors of dilation were identified using a Cox proportional hazards model. Among 237 patients (168 in Group C, 69 in Group P), 150 matched patients (100 in group C, 50 in group P) were analyzed. The median age and weight at surgery were 9.9 months and 7.5 kg, and conduit diameters ranged from 12 to 18 mm. No significant differences in 5-year overall survival, conduit explantation-free survival, or conduit dysfunction-free survival were found between the 2 groups. In patients with smaller conduits (12-14 mm), 5-year conduit stenosis-free survival was significantly lower in Group P compared to Group C (38.3% vs 63.1%; P = .027). Excessive conduit dilation occurred only in Group C. Independent predictors of dilation included truncus arteriosus (hazard ratio [HR], 3.30; P = .017), presence of major aortopulmonary collateral arteries (MAPCA) (HR, 7.98; P < .001), and conduit size (HR, 0.59; P = .001). BJV and PTFE valved conduits demonstrate comparable durability; however, smaller PTFE conduits are more susceptible to stenosis, while BJV conduits may dilate excessively in patients with truncus arteriosus, MAPCA, or smaller conduit size.