Right ventricular outflow tract reconstruction with valved bovine jugular vein conduit

Abstract

Objectives: Management for the repair of many congenital complex heart defects may require the implantation of a valved conduit into the right ventricular outflow-tract (RVOT). The Venpro ContegraTM conduit (CVC) is a bovine jugular vein graft, bearing a tri-leaflet venous valve. The aim of this study is to evaluate the short- and medium-term follow-up after implantation. Methods: 5/2000–8/2006: 14 patients (mean age 3.6 years, range 1 month to 9 years), of mean body weight 14.2kg (range 3.4–39.0kg) were operated using a CVC (12–20mm). Nine patients underwent primary repair and five had other previous operations. Mean follow-up: 46 months (14–81 months). Results: There were no hospital deaths. All RVOT reconstructions could be performed without any additional material, utilizing the surplus tissue on both ends of the CVC graft. At 12 months follow-up time all patients were in good clinical condition. However, one patient underwent balloon dilatation 11 months after operation. Freedom from reoperation and intervention at 1 year is 92,9%. Two patients required conduit exchange - 1.- endocarditis with vegetations two years after implantation and 2.- after 26 months, a 12mm CVC graft caused stenosis with gradient 64mmHg – which was replaced with a pulmonary homograft. All other conduits perform well. We have not observed thrombosis or thromboembolism. Conclusions: The readily available Contegra conduit seems to be a suitable alternative to homografts for RVOT-reconstruction in infants and young children. Of special appeal are its pliability and excellent handling-qualities.