# Outcomes of Bovine Jugular Vein Versus Porcine Valved Conduits for Right Ventricle to Pulmonary Artery Connection

## TL;DR

This study compares bovine and porcine conduits for heart surgery in children, finding better survival and fewer reinterventions with the bovine option.

## Contribution

The study provides new comparative evidence on the long-term outcomes of two xenograft conduits used in right ventricle to pulmonary artery connections.

## Key findings

- Contegra (bovine) conduits showed significantly higher 10-year survival rates (90% vs. 33.9%) compared to Biointegral (porcine) conduits.
- Fewer reinterventions were needed with Contegra conduits (30.5% overall vs. 33.3% in Biointegral group).
- Contegra conduits demonstrated superior freedom from reintervention at 10 years (47.1% vs. 0% in Biointegral).

## Abstract

Homografts conduits has been the gold standard for right ventricle to pulmonary artery (RV-PA) conduit. Several different types of xenograft valved conduits have been used as an alternative to homografts, due to their limited availability. In this single center, retrospective study, we analyzed the outcomes of patients with bovine jugular vein conduit (Contegra) and porcine valved conduit (Biointegral) in terms of survival and reintervention rate. Between 2012 and 2023, 44 children underwent surgical repair with RV-PA conduits using Contegra (n = 20) or Biointegral (n = 24). Patients with truncus arteriosus and patients who underwent unifocalization and Ross procedures were excluded. The operations in which other RV-PA conduits such as homografts, Gore-Tex grafts with PTFE handmade valved were used, were also excluded from the study. The median age of the patients was 19 (3–60) months and 84% of the patients (n = 37) had a history of previous intervention. Hospital mortality was 4.5% (n = 2). The median length of stay in intensive care unit and hospital was 5 (2–63) and 19 (2–145) days, respectively. 36 of the patients (82%) were followed for a median of 68 (4.8–143.7) months. There was one late death in Contegra group and five late deaths in Biointegral group. Survival analysis revealed that 1, 5, and 10-year survival rates were 100%, 90%, and 90% in Contegra group and 81%, 76.2%, and 33.9% (p = 0.047) in Biointegral group, respectively. During follow-up period, 11 patients (30.5%) needed reintervention (n = 3 in Contegra; n = 8 in Biointegral group). Freedom from reintervention rates were 100%, 94.1%, and 47.1% at 1, 5, and 10 years in Contegra group and 100% and 63.3% at 1 and 5 years in Biointegral group, respectively (p = 0.024). In this study, the outcomes of Contegra conduits were statistically significantly better than Biointegral conduits. Contegra is still the most valuable alternative to homografts. We believe that the choice of conduit in the first surgery is an important decision that directly affects survival and re-intervention rates.