January 22, 2026Open Access

Meta-analysis of valved conduits in right ventricular outflow tract reconstruction: comparison of homograft, bovine jugular vein, and EPTFE valved conduits

Key Result

Bovine jugular vein conduits had a significantly higher incidence of infective endocarditis (6%) compared to homografts (2%) and ePTFE (1%), posing a risk that requires careful monitoring.

Key Points

This analysis aims to compare the performance of homograft, bovine jugular vein, and ePTFE valved conduits in right ventricular outflow tract reconstruction.
Conducted a meta-analysis using data from various databases including MEDLINE and Embase.
Included studies reporting outcomes like mortality, replacement rates, and infective endocarditis rates.
Utilized R software for evidence synthesis and assessed bias with the ROBINS-I tool.
No significant difference in mortality and replacement rates among the three conduits.
Bovine jugular vein showed a higher infective endocarditis incidence compared to homograft.
Overall mortality rates were 8% for homograft, 5% for bovine jugular vein, and 3% for ePTFE.
Replacement rates were 9% for both homograft and BJV, while it was 4% for ePTFE.
Infective endocarditis incidence for BJV was 6%, while homograft and ePTFE had 2% and 1%, respectively.

Structured PICO

Do bovine jugular vein and ePTFE valved conduits have comparable mortality, replacement rates, and infective endocarditis incidence compared to homograft in patients undergoing right ventricular outflow tract reconstruction?

Population

Patients undergoing right ventricular outflow tract (RVOT) reconstruction (pooled from 28 retrospective cohort studies with n=3,966 and 113 case-series reports with n=16,367)

Intervention

Bovine jugular vein (BJV) and expanded polytetrafluoroethylene (ePTFE) valved conduits

Comparator

Homograft valved conduits

Outcome

Mortality, replacement rate, and incidence of infective endocarditishard clinical

Bovine jugular vein and ePTFE are viable alternatives to homograft for RVOT reconstruction with comparable mortality and replacement rates, though BJV carries a significantly higher risk of infective endocarditis.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: Homograft, bovine jugular vein (BJV) and expanded polytetrafluoroethylene (ePTFE) valved conduits are most common valved conduits for reconstructing right ventricular outflow tracts (RVOT), while the performance of those three valved conduits was still unclear. Materials and methods: We searched Ovid MEDLINE, Ovid Embase, as well as Chinese databases of SinoMed, CNKI, and Wanfang from 1 January 2000 to 26 August 2024 to identify studies on RVOT reconstruction with homograft, BJV, and ePTFE valved conduits. We included studies reporting the outcomes of mortality, replacement rate, and the incidence of infective endocarditis. The “meta” and “metafor” packages in R version 4.2.1 were used for evidence synthesis. ROBINS-I tool was used for assessing the risk of bias. This study is registered on PROSPERO (CRD42024582184). Results: According to 28 retrospective cohort studies ( n = 3966), there was no significant difference in mortality and replacement rate between homograft, BJV, and ePTFE. However, the IE incidence in BJV was significantly higher than that in homograft (RR = 3.63, 95% CI: 1.69–7.83, P < 0.01). Based on the pooled results of 113 case-series reports ( n = 16 367), the total mortality of homograft, BJV, and ePTFE was 8% (95% CI: 6%–9%), 5% (95% CI: 4%–7%), and 3% (95% CI: 3%–4%), respectively. The replacement rate of homograft, BJV, and ePTFE was 9% (95% CI: 6%–13%), 9% (95% CI:6%–12%), and 4% (95% CI: 2%–9%), respectively. The incidence of IE for BJV was 6% (95% CI: 3%–10%), which was higher than 2% for homograft (95% CI: 1%–4%) and 1% for ePTFE (95% CI: 1%–2%). Conclusions: While BJV and ePTFE are viable alternatives with comparable mortality and replacement rate to homograft, the elevated IE risk in BJV necessitates cautious patient selection and monitoring.