Durability of Porcine and Jugular Vein Small Sized Conduits for the Reconstruction of the Right Ventricular Outflow Tract – Is There a Difference?

Objectives: Since homografts are difficult to obtain, especially in small sizes, we sought to review our results with commercially available conduits in patients requiring a reconstruction of the right ventricular outflow tract.

Methods: Comparison of durability between bovine jugular vein conduits (BJVC) and porcine-valved conduits (PVC) in patients weighing less than 10 kg. Study endpoint was conduit exchange for any reason.

Results: Between 1994 and 2011, PVC was implanted in 67 patients and a BJVC in 47 patients. Median age at operation was 6.7 months, mean weight 5.9 ± 2.4 kg, mean conduit diameter was 12.9 ± 1 mm and mean Z-score was 1.74 ± 0.9. There were no differences between groups. A conduit exchange was necessary in 59% of patients with a PVC (n= 38) and 52% of patients with a BJVC (n= 22, p= 0.5). Freedom from conduit exchange was 91.0 ± 3.8%; 52.4 ± 7.4% and 18.4 ± 6.3% for PVC, and 80.5 ± 6.2%; 55.2 ± 7.9%, and 42.3 ± 9% for BJVC at 1, 5, and 10 years, respectively (p= 0.5). In the multivariate cox regression analysis, the only risk factor for conduit exchange was age below 1 month (HR 3.1, CI: 1.3 – 7.7, p= 0.004).

Conclusion: Although bovine jugular vein conduits tend to require an earlier exchange than porcine-valved conduits, in the long-term there is no difference in durability for both conduits. If possible, a conduit placement in patients below the age of 1 month should be avoided.