ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Thierry P. Carrel
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Göber, V.
Right arrow Articles by Carrel, T. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Göber, V.
Right arrow Articles by Carrel, T. P.
Related Collections
Right arrow Congenital - cyanotic

Ann Thorac Surg 2005;79:625-631
© 2005 The Society of Thoracic Surgeons


Original article: Cardiovascular

Adverse Mid-Term Outcome Following RVOT Reconstruction Using the Contegra Valved Bovine Jugular Vein

Volkhard Göber, MDa, Pascal Berdat, MDa, Mladen Pavlovic, MDb, Jean-Pierre Pfammatter, MDb, Thierry P. Carrel, MDa,*

a Clinic for Cardiovascular Surgery, Berne, Switzerland
b Division of Pediatric Cardiology, University Hospital, Berne, Switzerland

Accepted for publication July 29, 2004.

* Address reprint requests to Dr Carrel, Clinic for Cardiovascular Surgery, University Hospital, CH-3010 Berne, Switzerland (E-mail: thierry.carrel{at}insel.ch).

BACKGROUND: Current techniques for repair of the right ventricular outflow tract (RVOT) may require interposition of a valved conduit between the right ventricle and the pulmonary artery bifurcation. Recently, the Contegra conduit (Medtronic, Inc.) was introduced as an alternative xenograft tissue for RVOT reconstruction. Promising early hemodynamic and clinical results have been reported so far, but still less is known about mid-term adverse outcome.

METHODS: A total of 38 Contegra valved conduits (12 to 22 mm) were implanted from October 1999 to June 2004, in 36 children less than 5 years old and in 2 patients 8 and 21 years old. Diagnosis included the following: tetralogy of Fallot (n = 21); pulmonary atresia (n = 4); double outlet right ventricle + pulmonary stenosis (n = 3); d-transposition of the great arteries, ventricular septal defect, and pulmonary stenosis (n = 3); truncus arteriosus (n = 3); and other complex malformations (n = 4).

RESULTS: There was no mortality following initial surgery and no valved-conduit–related early morbidity. Early postoperative echocardiographic assessment after 3 months demonstrated favorable hemodynamics in all patients. However, during further follow-up, 5 conduits had to be replaced because of severe stenosis at the level of the distal anastomosis (2 of them had moderate to severe dilatation of the conduit proximally to the valve). Excessive intimal peel formation and severe perigraft scarring reaction were observed in all cases. One child died before surgery.

CONCLUSIONS: The Contegra valved conduit is an interesting concept for reconstruction of the RVOT. However, because of unpredictable incidence of supravalvar stenosis during mid-term results, we cannot recommend routine use of this material.




This article has been cited by other articles:


Home page
J Am Coll CardiolHome page
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al.
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease) Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
J. Am. Coll. Cardiol., December 2, 2008; 52(23): e143 - e263.
[Full Text] [PDF]


Home page
CirculationHome page
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al.
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
Circulation, December 2, 2008; 118(23): e714 - e833.
[Full Text] [PDF]


Home page
Eur. J. Cardiothorac. Surg.Home page
C. D. Derby, J. Kolcz, S. Gidding, and C. Pizarro
Outcomes following non-valved autologous reconstruction of the right ventricular outflow tract in neonates and infants
Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 726 - 731.
[Abstract] [Full Text] [PDF]


Home page
Eur. J. Cardiothorac. Surg.Home page
E. J. Hickey, B. W. McCrindle, E. H. Blackstone, T. Yeh Jr., F. Pigula, D. Clarke, C. I. Tchervenkov, J. Hawkins, and the CHSS Pulmonary Conduit Working Group
Jugular venous valved conduit (Contegra(R)) matches allograft performance in infant truncus arteriosus repair
Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 890 - 898.
[Abstract] [Full Text] [PDF]


Home page
ICVTSHome page
A. F. Corno and E. S. Mickaily-Huber
Comparative computational fluid dynamic study of two distal Contegra conduit anastomoses
Interactive CardioVascular and Thoracic Surgery, February 1, 2008; 7(1): 1 - 5.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
N. Sekarski, H. van Meir, M. E.B. Rijlaarsdam, P. H. Schoof, D. R. Koolbergen, J. Hruda, L. K. von Segesser, E. J. Meijboom, and M. G. Hazekamp
Right Ventricular Outflow Tract Reconstruction With the Bovine Jugular Vein Graft: 5 Years' Experience With 133 Patients
Ann. Thorac. Surg., August 1, 2007; 84(2): 599 - 605.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
J. Sierra, J. T. Christenson, N. H. Lahlaidi, M. Beghetti, and A. Kalangos
Right Ventricular Outflow Tract Reconstruction: What Conduit to Use? Homograft or Contegra?
Ann. Thorac. Surg., August 1, 2007; 84(2): 606 - 611.
[Abstract] [Full Text] [PDF]


Home page
Eur. J. Cardiothorac. Surg.Home page
I. Kaczmarek, D. Schmauss, B. Reichart, and S. H. Daebritz
Complete autologous reconstruction of the aorta and the pulmonary bifurcation in truncus arteriosus communis.
Eur. J. Cardiothorac. Surg., October 1, 2006; 30(4): 675 - 677.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
A. J. Rastan, T. Walther, I. Daehnert, J. Hambsch, F. W. Mohr, J. Janousek, and M. Kostelka
Bovine jugular vein conduit for right ventricular outflow tract reconstruction: evaluation of risk factors for mid-term outcome.
Ann. Thorac. Surg., October 1, 2006; 82(4): 1308 - 1315.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
D. L.S. Morales, B. E. Braud, K. S. Gunter, K. E. Carberry, K. A. Arrington, J. S. Heinle, E. D. McKenzie, and C. D. Fraser Jr
Encouraging results for the Contegra conduit in the problematic right ventricle-to-pulmonary artery connection.
J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 665 - 671.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
C. Schreiber, S. Sassen, M. Kostolny, J. Horer, J. Cleuziou, M. Wottke, K. Holper, F. Fend, A. Eicken, and R. Lange
Early graft failure of small-sized porcine-valved conduits in reconstruction of the right ventricular outflow tract.
Ann. Thorac. Surg., July 1, 2006; 82(1): 179 - 185.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
E. R. V. Buechel, H. H. Dave, C. J. Kellenberger, A. Dodge-Khatami, R. Pretre, F. Berger, and U. Bauersfeld
Remodelling of the right ventricle after early pulmonary valve replacement in children with repaired tetralogy of Fallot: assessment by cardiovascular magnetic resonance
Eur. Heart J., December 2, 2005; 26(24): 2721 - 2727.
[Abstract] [Full Text] [PDF]


Home page
Eur. J. Cardiothorac. Surg.Home page
S. Mohammadi, E. Belli, I. Martinovic, L. Houyel, A. Capderou, J. Petit, C. Planche, and A. Serraf
Surgery for right ventricle to pulmonary artery conduit obstruction: risk factors for further reoperation
Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 217 - 222.
[Abstract] [Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2005 by The Society of Thoracic Surgeons.