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Thorac Cardiovasc Surg 2009; 57(5): 257-269
DOI: 10.1055/s-0029-1185513
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

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

T. Breymann1 [*] , U. Blanz2 , M. A. Wojtalik3 , W. Daenen4 , R. Hetzer5 , G. Sarris6 , G. Stellin7 , C. Planche8 , V. Tsang9 , N. Weissmann10 , D. Boethig1 , 11 [*]
  • 1Cardiac, Thoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
  • 2Cardiac Surgery, Heart Centre North-Rhine Westphalia, Bad Oeynhausen, Germany
  • 3Department of Pediatric Cardiac Surgery, University of Medical Sciences, Poznan, Poland
  • 4Cardiac Surgery, Gasthuisberg University Hospital, Leuven, Belgium
  • 5Cardiac Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
  • 6Pediatric and Congenital Heart Surgery, Mitera Children's and Hygeia Hospitals, Athens, Greece
  • 7Cardiac, Thoracic, and Vascular Sciences, University of Padova Medical School, Padova, Italy
  • 8Cardiac Surgery, Centre Hospitalier Marie Lannelongue, Le Plessis-Robinson, France
  • 9Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children, London, United Kingdom
  • 10Cardiovascular Research Institute, Washington Hospital Center, Washington DC, Washington, United States
  • 11Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany
Further Information

Publication History

received October 27, 2008

Publication Date:
23 July 2009 (online)

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Abstract

Objective: The valved bovine conduit “Contegra” for RVOT reconstruction became available for clinical use within a 100 % source data monitored and echo core lab controlled prospective European Multicentre Study, carried out from 1999 to 2006. We present the results of this study. Methods: A total of 165 Contegras were implanted in 8 centres. The mean patient age was 3.9 years (2 days – 18 years, median 2.0). Total follow-up was 687 patient years. Diagnoses included: tetralogy of Fallot (64 patients, 39 %), truncus arteriosus (50, 30 %), double outlet right ventricle (16, 10 %), aortic valve disease/Ross procedure (11, 7 %), pulmonary valve atresia (10, 6 %), transposition of the great arteries (10, 6 %), 4 other malformations (2 %). Previous procedures were: 82 patients (50 %) – none; 37 (22 %) – valved conduit implantation; 14 (8 %) aortopulmonary shunt; 6 (4 %) catheter intervention. Follow-up appointments which included standardised echocardiography investigations were scheduled at 1, 3, 6, and 12 months, then annually. We evaluated freedom from death, explantation, intervention, stenosis, insufficiency, and degeneration. Results were stratified by age, diagnosis group and conduit size. Results: The 5-year freedom-from rates were: explantation – 90 % (for patients aged 1 to 10 years) and 68 % (for younger patients); endocarditis – over 92 %; catheter intervention – 74 % (patients with congenital malformations); stenosis – 75 % and more (any group); insufficiency – 50 % (12 and 14 mm diameter conduits); any event – 13 % (patients under 1 year), 58 % (1 to 10 years), 82 % (> 10 years). Trace or mild insufficiency was a frequent, but not progressive finding. Mild calcification was detected in only 8 examinations. Conclusions: The performance of the Contegra conduit compares well with that of homografts when used to reconstruct paediatric right ventricular outflow tracts.

Key words

heart valve surgery - right ventricular outflow tract - bovine valved conduit - long‐term follow‐up - homograft

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1 T. Breymann and D. Boethig are equally contributing authors.

Dr. Dietmar Boethig

Cardiac, Thoracic, Transplant and Vascular Surgery
Hannover Medical School

Carl-Neuberg-Str. 1

30625 Hannover

Germany

Phone: + 49 (0) 51 15 32 94 24

Fax: + 49 (0) 51 15 32 84 19

Email: boethig.dietmar@mh-hannover.de

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