Objective : to assess the results of RVOT-reconstruction with bovine jugular vein (Contegra®) grafts.
Methods : 52 Contegra® prostheses were used in 48 patients. Median age was 11 (range: 0,1- 334 ) months. 38 prostheses were used for biventricular correction of Fallot's tetralogy (3), PA, VSD, MAPCA's (13), absent pulmonary valve syndrome (3), truncus arteriosus (8), TGA/ DORV, VSD and PS (6), aortic atresia with VSD (2) or for a Ross procedure (3). 10 grafts were implanted to replace obstructed homografts (7) or to correct pulmonary regurgitation following Fallot repair (3). 4 patients received a second Contegra® graft during reoperation for PA branch stenosis (2) or endocarditis (2).
Echocardiographic follow-up was performed at 3 months intervals and is complete in all patients. Mean follow-up is 14 ± 8 months.
Results : Non-graft related mortality occurred in 3 patients. All remaining grafts have gradients of maximally 10 mm Hg with exception of one conduit with a gradient of 40 mm Hg due to sternal compression. Valvular insufficiency was moderate in 5 patients with distal PA branch stenosis (2), pulmonary hypertension (1), endocarditis (1) or sternal compression (1). Two patients with distal stenosis and another with pulmonary hypertension showed significantly dilated grafts. All other patients have absent to mild conduit insufficiency. Signs of calcific degeneration were not observed.
Conclusion : 90% of the Contegra® conduits used for RVOT reconstruction remained free of obstruction or more than mild regurgitation. In 10 % of the implanted grafts, dysfunction was related to suprasystemic conduit pressure, endocarditis or external compression.