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DOI: 10.1055/s-2007-967326
Mid-term results of the Contegra bovine jugular vein conduit for right ventricular outflow tract reconstruction in children
Objectives: The ideal alternative to homografts for valved reconstruction of the right ventricular outflow tract (RVOT) in children is undetermined. This study evaluates the Contegra bovine jugular venous conduit in mid-term.
Methods: Since 12/1999, the Contegra conduit was implanted in 25 patients, of whom 40% were younger than 1 year (mean age: 2.6±3.5 years). Indications were truncus arteriosus (n=6), pulmonary atresia with ventricular septal defect (n=10), tetralogy of Fallot (n=4), Ross procedure (n=2), and others (n=3). Fifty-six percent were redo operations.
Results: There were 2 (8%) hospital deaths, both not valve related. Discharge echocardiography revealed no or trivial conduit valve insufficiency in 90% and a calculated mean peak systolic transvalvular gradient of 9.5±6.2mmHg. Follow-up was complete (mean 44±17 months, range 2–72 months). During follow-up, 6/23 Contegra conduits had to be replaced because of conduit valve insufficiency (n=2), conduit valve stenosis (n=1), and severe stenosis at the distal anastomosis combined with conduit dilatation (n=3). Mean time to replacement was 3.5±1.96 years. Explantation-free survival was 96%, 91%, and 58% at 1, 3, and 5 years respectively. At latest follow-up, echocardiography showed a mean peak systolic transvalvular gradient of 16±15.8mmHg (4 patients with gradients of 30–50mmHg), with moderate insufficiency in 2 of 17 remaining patients.
Conclusion: Although the initial results of the Contegra conduit were encouraging, in mid-term conduit (valve) degeneration and distal anastomosis stenosis occurred unpredictable. The Contegra conduit can not be regarded as an ideal conduit for RVOT reconstruction.