The Follow-up Of Bovine Jugular Vein(BJV) To Reconstruct The Rightventricular Outflow Tract: Early And Medium Term Results

Object:Retrospectively analysis the postoperative and medium-term follow-up data of our patients whose right ventricular outflow tract reconstructed with decellularized and photo-oxidation bovine jugular vein (BJV), to evaluate the clinical result of this substitution material of pulmonary artery.Patients and Methods:124 consecutive patients adopt bovine jugular vein conduit (BJVC) to reconstruct(n=29) or widen(n=95) the ventricular outflow tract, respectively, between April 2007 and April 2011 in the second hospital of XiangYa and the cardiovascular disease hospital of Asia. All these patients underwent primary repair. Among the total, there are 76 tetralogy of Fallot(TOF),26 double outlet of right ventricle with pulmonary stenosis(PS),11 pulmonary atresia(PA) with ventricular septal defect(VSD),3 common arterial trunk with VSD,4 transposition of great arteries (TGA) with PS; 75 males and 49 females; the age from 5 month to 33-year-old with the average of 86.3-month-old, the weight from 5kg to 49kg with the average of 17.5kg. Part of the patients exist major aortopulmonary collaterals underwent intervention block the branch stem preoperative(n=14) or postoperative(n=37), respectively, and 25 patients ligated the branch intraoperative. Echocardiogram was made to evaluate the clinical result prior to discharge and follow-up period. All the dataes have been recorded such as the pulmonary artery size, pressure gradient of the pulmonary artery, activity of the valve, whether there are calcification and thrombus or not, the anastomotic stoma stenosis or not. SPSS 16.0 was employed to analyze the statistic like a retrospective studyResults:All the patients accepted follow-up. During the follow-up within 2-48 months, there is no death, and no life-threatening arrhythmia, and no reoperation because of conduit distortion, valve calcification, regurgitation or thrombus and so on. The New York Association functional class of all the patients go betweenⅠ-Ⅱlevel.With regard to the 29 patients of using BJVC to reconstructed the right ventricular outflow tract Compared with follow-up period and postoperative, the size of pulmonary artery trunk has not obviously change (P>0.05); the valve has no calcification, and did not increase the degree of regurgitation obviously, with regard to the 29 patients of using BJVC to reconstructed the right ventricular outflow tract Compared with follow-up phase and postoperative,The pressure gradient(PG) of pulmonary valve was 13.1±4.3mmHg, the PG of the side of pulmonary was 20.9±4.5mmHg, the PG of the side of right ventricular was 9.9±4.2mmHg in early-term. In the follow-up phase, The PG of pulmonary valve was 15.1±4.3mmHg,the PG of the side of pulmonary was 23.2±4.5mmHg, the PG of the side of right ventricular was 10.3±4.2mmHg.The PG of pulmonary valve,the side of pulmonary and right ventricular did not change obviously (P>0.05).only 2 of these patients who were implantded with BJVC had a obvious increase in the PG of the side of pulmonary which was more than 50 mmHg,one of them whose PG of the side of pulmonary was more than 60 mmHg was waiting for intervention expantion.With regard to the 29 patients of using BJV to widened the right ventricular outflow tract Compared with follow-up phase and postoperative:Pulmonary reguition did not increase obviousely (P>0.05),the side of right ventricular did not increase obviousely (P>0.05),too. the function of pulmonary was satisfied,calcification was not obciously,as well as thrombus.Conclusion The follow-up data of using decellularized and photo-oxidation bovine jugular vein to reconstructe or widen the righr ventricular outflow tract shows satisfaction early and metaphase clinical outcome. The BJVC had upstanding morphology and hemodynamics character, and was a suitable substitution material of pulmonary artery.