Surgery for congenital heart disease
Encouraging results for the Contegra conduit in the problematic right ventricle–to–pulmonary artery connection

https://doi.org/10.1016/j.jtcvs.2006.03.061Get rights and content
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Objective

The Contegra conduit was developed for right ventricular outflow tract reconstruction. This report evaluates the Contegra conduit, with focus on certain subpopulations in which conduits are known to perform poorly (ie, patients with previous homograft conduits and infants).

Methods

A retrospective review of 76 patients who had 77 Contegra conduits placed for right ventricular outflow tract reconstruction (January 2001 through August 2005) was completed. Characteristics include the following: median age of 1.6 years (range, 17 days–15.1 years), weight of 9.8 kg (range, 2.5–64.0 kg), and conduit diameter of 16 mm (range, 12–22 mm). Operations performed include right ventricular outflow tract reconstruction for pulmonary atresia–stenosis (n = 33), conduit exchange (n = 28), truncus repair (n = 7), primary conduit placement (n = 6), and the Ross procedure (n = 3). Seventy-nine percent were reoperations.

Results

There was no hospital mortality. Mean follow-up was 20 ± 14 months. One-, 2-, and 3- year freedom from severe conduit regurgitation was 97%, 86%, and 81%, respectively, and freedom from severe conduit stenosis was 100%. Freedom from reoperation for conduit failure at 1 and 3 years is 98.3% and 93.1%, respectively. All conduit failures (n = 3) were for asymptomatic conduit pseudoaneurysms in the setting of multiple-level pulmonary branch stenoses. Survival at 3 years is 96%. Infants (n = 26) had a freedom from Contegra conduit failure at 3 years of 100%. Patients with previous homograft conduits (n = 26) had a freedom from Contegra conduit failure at 3 years of 100%.

Conclusion

At midterm follow-up, the Contegra conduit remains a reliable, accessible, and easily implantable conduit for right ventricular outflow tract reconstruction. It appears to be the most promising conduit option for patients with previous homograft conduits and for infants.

CTSNet classification

21
35

Abbreviations and Acronyms

CI
confidence interval
CPB
cardiopulmonary bypass
PA
pulmonary artery
PAR
pulmonary artery resistance
RV
right ventricle
RVOT
right ventricular outflow tract
TCH
Texas Children’s Hospital

Cited by (0)

Dr Morales

1

David L. S. Morales, Jeffrey S. Heinle, E. Dean McKenzie, and Charles D. Fraser report receiving a research grant from Medtronic Heart Valves, the manufacturer of the Contegra conduit.