Jugular venous valved conduit (Contegra®) matches allograft performance in infant truncus arteriosus repair☆

Abstract

JVV does match allograft performance and may be advantageous. It is an appropriate first choice for repair of truncus arteriosus, and perhaps other small infants requiring RVOT reconstruction.

Outcomes of truncus arteriosus repair with bovine jugular vein conduit

“…Patient-prosthesis mismatch has been cited as a reason for early failure and, therefore, there has been a demand for small pediatric allografts (<12 mm). [16] In conclusion, our study results suggest that Contegra conduit may be used for right ventricular outflow tract reconstruction in small infants with truncus arteriosus. Early surgical results are…”

“…The rates of freedom from conduit stenosis at three years were better for Contegra (96 to 69%). [16] It was also reported that the Contegra conduit responded better to catheter interventions, when stenosis developed. Neukamm et al [17] described that necessity for reoperations within the first two years was significantly lower for Contegra grafts than for non-blood group compatible cryopreserved homografts, two of 78 (2.6%) and eight of 20 (40.0%), respectively.…”

O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas

“…Right ventricle to left ventricle pressure ratio development and freedom from explantation/ redo were equal for the Contegra conduits and homografts 3 . The 3-year freedom from replacement for in-conduit stenosis was 96 ± 4% for the Contegra and 69 ± 8% for allograft 28 .…”

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

“…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).…”

“…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).…”