European Contegra Multicentre Study: 7-Year Results after 165 Valved Bovine Jugular Vein Graft Implantations

Breymann, Thomas; Blanz, Ute; Wojtalik, Michał; Daenen, Willem; Hetzer, Roland; Sarris, George E.; Stellin, Giovanni; Planché, C; Tsang, Victor; Weißmann, Norbert; Boethig, Dietmar

doi:10.1055/s-0029-1185513

Cited by 87 publications

(75 citation statements)

References 32 publications

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“…In our experience early conduit calcification causing hemodynamic consequences was never observed, confirming our own previous observations and those of other researchers (39,40,42,45).…”

Section: Bovine Jugular Veinsupporting

confidence: 81%

“…structural continuity between the wall of the jugular vein of the conduit and the valve leaflets, which provides optimal hemodynamics because of the ideal effective orifice area b. unlimited "off-the-shelf" availability in sizes from 12 to 22 mm diameter, representing a good alternative to the homograft shortage, particularly in the smaller sizes c. availability of a long length at both inflow and outflow that obviates the need for either proximal or distal augmentation; this facilitates conduit tailoring and positioning which helps to avoid potential distortion and sternal compression d. exceptional reports of antigenic reaction, due to glutaraldehyde fixation In contrast to the good clinical results obtained in several institutions (37)(38)(39)(40)(41)(42)(43)(44)(45), a disturbing sequence of publications reported stenosis at the level of the distal anastomosis of the conduit, with proximal conduit dilatation, aneurysm or pseudo-aneurysm, in between 6 and 50% of patients (39,40,42,(46)(47)(48)(49)(50)(51)(52)(53)(54).…”

Section: Bovine Jugular Veinmentioning

confidence: 99%

“…The bovine jugular vein (Contegra®, Medtronic Inc., Minneapolis, MN), containing a trileaflet valve, was introduced into clinical practice as an alternative to the use of homografts in 1999 and has provided encouraging results in several reported clinical series, with follow-up reaching more than 10 years (37)(38)(39)(40)(41)(42)(43)(44)(45).…”

Section: Bovine Jugular Veinmentioning

confidence: 99%

See 2 more Smart Citations

Valved Conduits Right Ventricle to Pulmonary Artery for Complex Congenital Heart Defects

Corno¹

2012

Current Concepts in General Thoracic Surgery

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“…In our experience early conduit calcification causing hemodynamic consequences was never observed, confirming our own previous observations and those of other researchers (39,40,42,45).…”

Section: Bovine Jugular Veinsupporting

confidence: 81%

Section: Bovine Jugular Veinmentioning

confidence: 99%

Section: Bovine Jugular Veinmentioning

confidence: 99%

See 1 more Smart Citation

Valved Conduits Right Ventricle to Pulmonary Artery for Complex Congenital Heart Defects

Corno¹

2012

Current Concepts in General Thoracic Surgery

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“…Clinical reports with short-term to mid-term follow-up described acceptable results and a low calcification rate with Contegra conduit, compared to other conduits. [14,15] In a multicenter study, the results of 107 patients who underwent TA repair with a homograft or a Contegra conduit were examined. The rates of freedom from conduit stenosis at three years were better for Contegra (96 to 69%).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of truncus arteriosus repair with bovine jugular vein conduit

Erek

Temur

Suzan

et al. 2018

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada Rastelli tipi trunkus arteriyozus olan hastalarda trunkus arteriyozus tamirinin sonuçları değerlendirildi.Çalışma planı: Ocak 2011 -Mart 2017 tarihleri arasında 13 hastaya (7 erkek, 6 kadın; medyan yaş 37 gün; dağılım, 16-60 gün) Contegra kondüiti kullanılarak trunkus arteriyozus tamiri yapıldı. Ameliyat öncesi tanı sekiz hastada trunkus arteriyozus tip 1 (Edwards-Collett), üç hastada tip 2, bir hastada tip 3 ve bir hastada tip 4 idi. Ameliyat için kullanılan Contegra kondüitleri 14 mm (n=5), 12 mm (n=7) ve 16 mm (n=1) idi. Bul gu lar:İki hastada (%15.4) erken ölüm görüldü. Medyan yoğun bakım ve hastanede kalış süreleri sırasıyla 10 (dağılım 6-14) ve 20 (dağılım 14-41) gün idi. Medyan takip süresi 36 (dağılım, 2-66) ay idi. Dört hastada (%31) takip sırasında kondüit boyutları ciddi şekilde artış gösterdi ve iki hastada 23 mm'ye, bir hastada 20 mm'ye ve diğer hastada 18 mm'ye ulaştı. Üç hastada orta derecede distal kondüit darlığı vardı. Dört hastada orta derecede pulmoner yetmezlik ve bir hastada ciddi pulmoner yetmezlik vardı. İki hastada orta derecede trunkal kapak yetmezliği ve bir hastada orta derecede rezidüel ventriküler septal defekt vardı. Hastaların hiçbirinde tekrar ameliyat gereksinimi olmadı.Sonuç: Contegra kondüiti bebeklerde trunkus arteriyozus tamiri için iyi bir alternatiftir; ancak, distal kondüit darlığı ve kondüit dilatasyonu gelişebileceği için yakın izlem gereklidir. ABSTRACT Background:In this study, we aimed to evaluate the outcomes of truncus arteriosus repair in patients undergoing Rastelli type truncus arteriosus.

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“…5 Then some more conduits exist with an artificial conduit from several materials. What they have in common is the biological valve inside.…”

Section: Complication and Risksmentioning

confidence: 99%

Ross Operation

Bennink¹

2015

MOJS

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ExaminationsAortic valve disease can be determined with echocardiography and depending on the age of the patient a heart catheterization is necessary to exclude coronary artery disease. If a heart catheterization is done then exact measurements can be taken to evaluate the degree of stenosis or regurgitation. The size of the pulmonary autograft can also be measured. OperationThe operation is done using the heart lung machine. The area between aorta and pulmonary artery stem is dissected and freed. Then after cardioplegia, the pulmonary autograft is harvested with some musculature from the right ventricle and some native tissue of the pulmonary artery stem. In the mean time the aorta has been opened and the condition has been inspected and both coronary have been isolated on buttons. After the diseased aortic valve has been excised, the autograft is put in place, either by inlay technique or as a free graft. The former sub coronary technique has been abandoned due to the technically more challenging aspect.In the proximal part the autograft is sewn into place and distally connected to the native aortic tissue. Both coronaries are re-implanted into the autograft, without kinking and traction. If all of this is finished the aortic clamp, to prevent beating of the heart can be released and the implantation of the right ventricle to pulmonary artery graft can be done with beating heart. The most often used graft is a homograft, either pulmonary or aortic homograft. Currently, there are several of these right ventricles to pulmonary artery graft available, both biological as with other tissue. However, the search towards the holy grail, growth potential, is still ongoing. Complication and risksIn the hands of experienced surgeons the operative risk of this procedure is slightly higher than with a normal valve replacement with either mechanical or biological valve. 4 The operation is more demanding for the surgeon and the patient due to longer ischemic time for the heart and the fact that one valve disease is repaired by a two valve procedure (aortic and pulmonary valve, which is a general argument used by non-believers). The normal complications that also can occur during a normal aortic valve replacement like atrioventricular block, bleeding etc. are in the same range with the Ross procedure. Other complications and risks that can occur are small to moderate aortic regurgitation due to pulling or mismatching of the autograft and in the long run calcification. Graft versus host reactions is rare with the use of homograft's, due to the conservation procedure. The grafts are frozen to-130 or-150degrees Celsius with nitric oxide and lose their immunological competence. All homograft's are tested on hepatitis and HIV. The disadvantage is the shortage of donor organs and there for the shortage of homograft's. From the substitutes of homograft's are various variants of which the jugular vein of the cow is the most promising (this is called Contegra R , Medtronic Inc).Up until now the short-term and long-term results of this...

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European Contegra Multicentre Study: 7-Year Results after 165 Valved Bovine Jugular Vein Graft Implantations

Abstract: The performance of the Contegra conduit compares well with that of homografts when used to reconstruct paediatric right ventricular outflow tracts.

Cited by 87 publications

References 32 publications

Valved Conduits Right Ventricle to Pulmonary Artery for Complex Congenital Heart Defects

Valved Conduits Right Ventricle to Pulmonary Artery for Complex Congenital Heart Defects

Outcomes of truncus arteriosus repair with bovine jugular vein conduit

Ross Operation

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