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December 15, 2021Journal of Thoracic and Cardiovascular SurgeryOpen Access

Comparison of homografts and bovine jugular vein conduits in the pulmonary position in patients <20 years of age

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Key result

In patients <20 years, pulmonary homografts had higher 10-year freedom from reintervention (80%) compared to bovine jugular vein conduits (37%, P<0.001) and aortic homografts (47%).

Why the study?

The study was conducted to compare the performance of homografts and bovine jugular vein conduits in the pulmonary position.

Do pulmonary homografts reduce reintervention, structural valve degeneration, and infective endocarditis compared to bovine jugular vein conduits in patients <20 years of age undergoing pulmonary valve replacement?

Population

Patients with congenital heart disease up to age 20 years receiving 674 conduits at 3 centers in Australia

Comparison

Pulmonary homografts vs bovine jugular vein conduits vs aortic homografts

Design

Multicenter propensity score-matched cohort study

Follow-up

Median 6.4 years

Authors

SMSupreet P MaratheNHNadia HusseinFWFraser R.O. Wallace

Discussion

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Overview

Pulmonary homografts may offer better durability than BJV conduits for larger sizes in patients <20 years; leaves open need for prospective trials before practice change.

Study Design

Type

Cohort (n=674)

Multicenter

Yes

Structured PICO

Do pulmonary homografts reduce reintervention, structural valve degeneration, and infective endocarditis compared to bovine jugular vein conduits in patients <20 years of age undergoing pulmonary valve replacement?

P
Population
674 conduits in patients up to age 20 years with congenital heart disease undergoing pulmonary valve replacement, followed for a median of 6.4 years.
E
Exposure
Pulmonary homografts (n=305) or aortic homografts (n=66)
C
Comparator
Bovine jugular vein (BJV) conduits (n=303)
O
Outcome
Freedom from reintervention, structural valve degeneration (SVD), and infective endocarditis (IE)hard clinical

Main Result

Absolute Event Rate: 80% vs 37%

p-value: p=<.001

In patients under 20 years of age requiring pulmonary valve replacement with conduits >15 mm, pulmonary homografts significantly outperform bovine jugular vein conduits and aortic homografts in freedom from reintervention and structural valve degeneration.

Cite This Study

Marathe et al. (2021) conducted a cohort in Congenital heart disease (n=674). Pulmonary homografts vs. Bovine jugular vein conduits and aortic homografts was evaluated on Freedom from reintervention at 10 years (p=<.001). In patients <20 years, pulmonary homografts had higher 10-year freedom from reintervention (80%) compared to bovine jugular vein conduits (37%, P<0.001) and aortic homografts (47%).

synapsesocial.com/papers/6a63d685f3f956990ff2de91https://doi.org/10.1016/j.jtcvs.2021.11.087
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Factors Affecting Longevity of Homograft Valves Used in Right Ventricular Outflow Tract Reconstruction for Congenital Heart Disease2000 · 249 citations
  2. 2Homografts versus stentless bioprosthetic valves in the pulmonary position: a multicentre propensity-matched comparison in patients younger than 20 years†2019 · 20 citations
  3. 3Factors influencing the survival of cryopreserved homografts. The second homograft performs as well as the first☆2005 · 79 citations