Application of a Simplified Hand-Sewn Trileaflet Valved Conduit in Right Ventricular Outflow Tract Reconstruction as...

The Bovine jugular vein (BJV) graft for right ventricular outflow tract reconstruction (RVOT) is limited applied due to possible graft failure. In this study, we reported the clinical application of simplified hand-sewn trileaflet valved conduit as an alternative for BJV graft. We retrospectively included 68 patients underwent 76 conduits implantation including 22 new simplified hand-sewn trileaflet valved conduits (Group A) and 54 BJV grafts (Group B). For patients in Group A, a hand-sewn trileaflet valved conduit with valves made of autologous pericardium or expanded polytetrafluoroethylene was applied. Baseline, perioperative, and outcomes were analyzed. No early mortality or perioperative complication occurred in Group A, while 2 patients died and 16 patients suffered from conduits failure due to conduits stenosis (n = 11), stenosis plus regurgitation (n = 3), and regurgitation alone (n = 2) in Group B. Freedom from BJV grafts failure within 1, 3, 5, and 7 years was 98.0%, 88.2%, 83.6% and 83.6% in Group A, and 98.0%, 85.8%, 76.8% and 62.1% in Group B. Endocarditis occurred in 9 patients in Group B, but not in Group A. Subsequent analysis showed that endocarditis is the only significant predictor of BJV grafts failure (odds ratio: 6.202, 95% confidence intervals 1.237∼31.108). The novel simplified hand-sewn trileaflet valved conduits seems to be associated with lower incidences of perioperative complication, graft failure, and early-phase mortality, as compared with conventional BJV grafts.