Risk Factor Analysis of 170 Single-Institutional Contegra Implantations in Pulmonary Position

Dave, Hitendu; Mueggler, Oliver; Comber, Maurice; Enodien, Bassey; Νικολάου, Γεώργιος; Bauersfeld, Urs; Jenni, Rolf; Béttex, Dominique; Prêtre, René

doi:10.1016/j.athoracsur.2010.07.058

Cited by 48 publications

(38 citation statements)

References 27 publications

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“…In a report among 170 Contegra implantations, four grafts implanted in high pulmonary pressure situations developed aneurysm formation needing replacement. [20] In our study, we used Contegra conduits for other different kinds of congenital pathologies; however, we did not observe any dilatation. Mechanisms involved for Contegra dilatation are not completely understood, although geometric distortion along with immunological rejection has been suggested.…”

Section: Discussionmentioning

confidence: 96%

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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Section: Discussionmentioning

confidence: 96%

Outcomes of truncus arteriosus repair with bovine jugular vein conduit

Erek

Temur

Suzan

et al. 2018

Turk Gogus Kalp Dama

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“…The size distribution was depicted in Figure 1. The mean conduit sizes were 14-20.4 mm from different reports 16,17,20,31,32,35 ( Figure 2). The median sizes were reported to be 16 mm 19 , and 20 mm 35 .…”

Section: Resultsmentioning

confidence: 99%

“…The actuarial survival rate was 85.7% at 5 years 23 , 93.1% ± 3.6% at 6 years 18 , and 91.5% ± 2.3% at 8 years 32 .…”

Section: Introductionmentioning

confidence: 93%

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

Yuan¹

2012

Arq. Bras. Cardiol.

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“…The insertion of a competent valve is an important step in the course of treating these patients to restore or preserve the function of their steadily dilating right ventricle and to prevent the development of ominous ventricular arrhythmias [3, 4]. The disadvantages of valvular prostheses are well known, the most important ones being the need for iterative replacement in the usual treatment of tissue valves and bacterial endocarditis [5][6][7]. The recycling of the native, viable pulmonary valve could circumvent all these problems and bring a long-term solution to these patients.…”

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confidence: 99%

Invited Commentary

Arsdell

2012

The Annals of Thoracic Surgery

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fenestrated leaflet) and was central in 3 patients. There was no more than a physiologic gradient (Ͻ 4 mm Hg) in the 5 patients with tricuspid valves and a gradient of 8, 16, and 23 mm Hg in the 3 patients with bicuspid valves, respectively. These operative findings remained fundamentally unchanged in all patients during follow-up.The patients all had a smooth recovery with same-day extubation and 1-to 2-night stays in the intensive care unit. There was no significant complication postoperatively or during follow-up. CommentRecycling of the pulmonary valve is an interesting concept in patients with tetralogy of Fallot and secondary chronic pulmonary regurgitation. The insertion of a competent valve is an important step in the course of treating these patients to restore or preserve the function of their steadily dilating right ventricle and to prevent the development of ominous ventricular arrhythmias [3, 4]. The disadvantages of valvular prostheses are well known, the most important ones being the need for iterative replacement in the usual treatment of tissue valves and bacterial endocarditis [5][6][7]. The recycling of the native, viable pulmonary valve could circumvent all these problems and bring a long-term solution to these patients.We have been surprised many times to see the size, morphologic characteristics, and quality of the residual leaflets in patients with tetralogy of Fallot. It appears, furthermore, that the leaflets have pursued their growth in accordance with the size of the main pulmonary artery and not with the somatic growth of the patient. This fact provides additional tissue for reconstruction. This explains the successful recycling of bicuspid valves without the induction of valvular stenosis.The surgical technique to recycle the pulmonary valve is extremely simple. It is important to sufficiently dissect the main pulmonary artery around the pulmonary annulus to allow its reapproximation (after resection of most of the transannular patch) in a round fashion. A mattress suture allows a precise approximation of the commissure and helps fashion by appropriate trimming both the main pulmonary artery and the infundibulum. We believe that the valve can be accurately assessed after reconstruction of the main pulmonary artery with injection of saline distal to the valve. Even if the saline rapidly flows through the lung bed, it still can give a good view of the expanding valve and would detect significant regurgitation. The complementary assessment of the valve with transesophageal echocardiography should definitively confirm the appropriateness of the recycling procedure. Even if it were decided at that time to change the valve, the additional patient time under cardiopulmonary bypass would not have exceeded 30 minutes and would be tolerated without significant additional morbidity.We must however emphasize that the conditions necessary to recycle the valve are seldom achieved. This technique represents only 15% of our secondary operations to correct chronic regurgitation. Still we believe that...

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Risk Factor Analysis of 170 Single-Institutional Contegra Implantations in Pulmonary Position

Cited by 48 publications

References 27 publications

Outcomes of truncus arteriosus repair with bovine jugular vein conduit

Outcomes of truncus arteriosus repair with bovine jugular vein conduit

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

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