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The Contegra conduit in the right ventricular outflow tract is an independent risk factor for graft replacement

Stefano Urso1, Filip Rega, Bart Meuris

  • 1Department of Cardiac Surgery, University Hospital Gasthuisberg, Leuven, Belgium. stefano_urso@inwind.it

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|February 23, 2011
PubMed

Insights

The Contegra conduit, a bovine jugular vein graft, showed a higher incidence of graft replacement compared to homografts in right ventricle outflow tract reconstructions. Patients receiving the Contegra conduit were over twice as likely to need re-operation.

Area of Science:

  • Cardiovascular Surgery
  • Biomaterials in Medicine
  • Congenital Heart Disease Treatment

Background:

  • Valved conduits are essential for right ventricle outflow tract (RVOT) to pulmonary artery continuity in congenital heart diseases.
  • Graft replacement is a significant concern in RVOT reconstruction.

Purpose of the Study:

  • To compare graft replacement rates between the Contegra conduit (bovine jugular vein graft) and homografts in RVOT reconstructions.
  • Identify risk factors for graft replacement in RVOT conduits.

Main Methods:

  • Retrospective review of 347 RVOT conduits (Contegra: 54, Homografts: 293) implanted between 1989-2003.
  • Follow-up of 323 patients (median age 12.7 years) with 99.4% completeness (mean 5.9 years).
  • Analysis of indications including Tetralogy of Fallot, Ross operation, and others.

Main Results:

  • Freedom from graft replacement at 10 years was lower for Contegra (63.5%) versus homografts (81.4%) (p < 0.001).
  • Independent predictors for graft replacement included smaller graft size (≤ 20 mm), younger age (≤ 10.4 years), non-anatomical graft position, and use of the Contegra conduit.
  • Multivariable analysis confirmed Contegra conduit use as an independent risk factor (HR 3.7).

Conclusions:

  • The Contegra conduit is an independent risk factor for graft replacement in RVOT reconstructions.
  • Patients receiving Contegra conduits face a significantly higher likelihood of re-operation compared to those receiving homografts.
  • Graft size, patient age, and graft position also significantly influence the need for replacement.
Abstract

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