Eugen Sandica1, Dietmar Boethig2, Ute Blanz1, Rainer Goerg3, Nikolaus Andreas Haas3, Kai Thorsten Laser3, Deniz Kececioglu3, Harald Bertram2, Samir Sarikouch4, Mechthild Westhoff-Bleck5, Philipp Beerbaum2, Alexander Horke4. 1. Clinic of Surgery for Congenital Heart Defects, Center for Congenital Heart Defects, Heart and Diabetes Center North-Rhine Westphalia, Bad Oeynhausen, Germany. 2. Clinic for Pediatric Cardiology and Pediatric Intensive Care Medicine, Hannover Medical School, Hannover, Germany. 3. Clinic for Pediatric Cardiology and Congenital Heart, Center for Congenital Heart Defects, Heart and Diabetes Center North-Rhine Westphalia, Bad Oeynhausen, Germany. 4. Clinic for Cardiac, Thoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany. 5. Clinic for Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Abstract
BACKGROUND: Various diseases and diversity in implantation ages, together with evolving diagnostic and therapeutic options, hinder comparative evaluations of long-term outcomes for valved conduits used for reconstruction of the right ventricular outflow tract (RVOT). We combined two common evaluation methods to optimally use information obtained by pooling the raw data from two high volume centers, each with very regular follow-up procedures, with the aim of analyzing durability differences between conventional homografts and bovine jugular veins. PATIENTS AND METHODS: In the period 1985 to 2012, a total of 444 bovine jugular veins and 267 homografts were implanted, and 6,738 postoperative examinations took place. Evaluations included age-stratified Kaplan-Meier analyses, Cox regression models, and time status graphs, the third showing age-group stratified, time-related frequencies of intact, insufficient, stenotic, both insufficient and stenotic, and postinterventional conduits below the freedom from explantation curve. They take into account interventions, explantations, and the nonterminal character of echocardiographic findings. RESULTS: The durability of intact bovine jugular veins in children and young adults is not inferior to that of homografts. Averaged over the first 12 years after implantation, the age groups < 25 years in fact showed advantages for bovine jugular vein recipients. The average fraction of patients younger than 25 years whose conduits were not explanted, postinterventional, stenotic, insufficient, or stenotic and insufficient was at least 10% higher in recipients of bovine jugular veins than in homograft recipients. CONCLUSION: According to the time status graphs, the use of bovine jugular veins for RVOT in patients younger than 25 years appears to lead to superior results when compared with cryopreserved homografts. Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND: Various diseases and diversity in implantation ages, together with evolving diagnostic and therapeutic options, hinder comparative evaluations of long-term outcomes for valved conduits used for reconstruction of the right ventricular outflow tract (RVOT). We combined two common evaluation methods to optimally use information obtained by pooling the raw data from two high volume centers, each with very regular follow-up procedures, with the aim of analyzing durability differences between conventional homografts and bovine jugular veins. PATIENTS AND METHODS: In the period 1985 to 2012, a total of 444 bovine jugular veins and 267 homografts were implanted, and 6,738 postoperative examinations took place. Evaluations included age-stratified Kaplan-Meier analyses, Cox regression models, and time status graphs, the third showing age-group stratified, time-related frequencies of intact, insufficient, stenotic, both insufficient and stenotic, and postinterventional conduits below the freedom from explantation curve. They take into account interventions, explantations, and the nonterminal character of echocardiographic findings. RESULTS: The durability of intact bovine jugular veins in children and young adults is not inferior to that of homografts. Averaged over the first 12 years after implantation, the age groups < 25 years in fact showed advantages for bovine jugular vein recipients. The average fraction of patients younger than 25 years whose conduits were not explanted, postinterventional, stenotic, insufficient, or stenotic and insufficient was at least 10% higher in recipients of bovine jugular veins than in homograft recipients. CONCLUSION: According to the time status graphs, the use of bovine jugular veins for RVOT in patients younger than 25 years appears to lead to superior results when compared with cryopreserved homografts. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Dietmar Boethig; Alexander Horke; Mark Hazekamp; Bart Meyns; Filip Rega; Joeri Van Puyvelde; Michael Hübler; Martin Schmiady; Anatol Ciubotaru; Giovanni Stellin; Massimo Padalino; Viktor Tsang; Ramadan Jashari; Dmitry Bobylev; Igor Tudorache; Serghei Cebotari; Axel Haverich; Samir Sarikouch Journal: Eur J Cardiothorac Surg Date: 2019-09-01 Impact factor: 4.191
Authors: Hari Iyer; Shahrzad Joharifard; Annie Le-Nguyen; Josée Dubois; Rafik Ghali; Daniel E Borsuk; Michel Lallier Journal: EJVES Vasc Forum Date: 2021-06-21