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Ann Thorac Surg 2004;77:1707-1710
© 2004 The Society of Thoracic Surgeons

Original article: cardiovascular

Contegra bovine jugular vein right ventricle to pulmonary artery conduit in Ross procedure

Manoj Purohit, MCha*, Denise Kitchiner, FRCPCHa, Marco Pozzi, FECTSa

a Cardiac Unit, Royal Liverpool Children's Hospital, Liverpool, England, UK

Accepted for publication October 2, 2003.

* Address reprint requests to Dr Purohit, Paediatric Cardiac Surgery, Alder Hey Hospital, Eaton Rd, Liverpool L12 2AP, UK, UK
e-mail: drpurohitm{at}yahoo.com

BACKGROUND: In the Ross procedure a valved conduit, most commonly pulmonary or aortic homograft, is used in place of autotransplanted pulmonary valve. Increasing demand and diminishing supply of homografts has resulted in a search for alternatives. A biological conduit from the valved segment of bovine jugular vein (Contegra) has been used successfully as an alternative.

METHODS: Early clinical and echocardiographic results were analyzed retrospectively for 20 patients (median age 14.4 years) who underwent a Ross procedure with Contegra as right ventricle to pulmonary artery conduit between November and June 2003 (during the last 31 months).

RESULTS: There was no operative mortality and late mortality or morbidity during the mean follow-up of 13.8 ± 9.1 months (range 1 to 31 months). No patient required reoperation. The median gradient at discharge was 16 ± 4.5 mm Hg, which remained unchanged at last follow-up. No deterioration in conduit or conduit valve function was noted.

CONCLUSIONS: This new bovine jugular vein conduit can be a viable alternative to a homograft in the Ross procedure. The early clinical and hemodynamic results are encouraging. Ease of availability and favorable handling and technical characteristics make it more attractive than a homograft. Xenograft origin of this conduit necessitates close follow-up for assessment of durability and longer-term results.




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