EJCTS Click here to go to Edwards website
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Dietmar Boethig
Thomas Breymann
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Boethig, D.
Right arrow Articles by Breymann, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Boethig, D.
Right arrow Articles by Breymann, T.
Related Collections
Right arrow Congenital - acyanotic
Right arrow Congenital - cyanotic
Right arrow Great vessels
Right arrow Valve disease

Eur J Cardiothorac Surg 2005;27:58-66
© 2005 Elsevier Science NL

Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras

Dietmar Boethiga, Wolf-Rüdiger Thiesb, Hartmut Heckerc, Thomas Breymannd,*

a Department for Pediatric Cardiology and Intensive Care, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
b Pediatric Cardiology Practice, Karmarschstr. 36, D-30159 Hannover, Germany
c Institute of Biometrics, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
d Department of Surgery for Congenital Heart Disease, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany

Received 9 February 2004; received in revised form 12 August 2004; accepted 1 September 2004.

* Corresponding author. Tel.: +49 511 532 9828; fax: +49 511 532 9832. (E-mail: breymann{at}thg.mh-hannover.de).

Objective: Homografts and porcine xenografts are valved conduits for pediatric RVOT reconstruction. They lack availability and durability. The Contegra, a glutaraldehyde fixed bovine jugular vein, was developed as an alternative. In this article, we compare single center results of 190 RVOT conduit implantations. Methods: 52 homografts, 30 porcine xenografts, 108 Contegras were implanted since 1992. Since 1999, data collection was prospective, for Contegras within a controlled clinical trial. Follow-up is complete for all evaluated items. We stratified reoperations by problem zone (sub-, intra-, and supravalvular) and analyzed the role of patient age, diagnosis, graft type, graft size, previous operations and year of operation on freedom from explantation or reoperation related to supravalvular reasons. Results: Porcine xenografts were inferior concerning freedom from explantation and reoperation (P<0.0001). They gave erlier reason for explantation in each zone (P<0.001). At 4 years, homograft valve related reoperation need reached 20%, Contegras 0% (P=0.002). Supravalvlar reoperation reasons developed about equally in homografts and Contegras. Multivariable Cox' regression analysis showed porcine xenografts and age <1 year as independent risk factors for explantation due to supravalvular reasons. We found no reason to assume that supravalvular reoperation reasons occured more frequently after Contegra than after homograft implantation. Conclusion: After 12 years RVOT reconstruction with 190 valved conduits, Contegras remain our device of choice. At 4 years, they show no subvalvular or valvular reason for explantation or reoperation. Contegras have the advantages of easy handling and availability, and they compare well with homografts regarding freedom from explantation and freedom from reoperation.

Key Words: Right ventricular outflow tract • Conduit durability • Congenital cardiac surgery • Contegra




This article has been cited by other articles:


Home page
 ICVTSHome page
L. Niclauss, D. Delay, M. Hurni, and L. K. von Segesser
Experience and intermediate-term results using the Contegra(R) heterograft for right ventricular outflow reconstruction in adults
Interactive CardioVascular and Thoracic Surgery, October 1, 2009; 9(4): 667 - 671.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
J. Nordmeyer, V. Tsang, R. Gaudin, P. Lurz, A. Frigiola, A. Jones, S. Schievano, C. van Doorn, P. Bonhoeffer, and A. M. Taylor
Quantitative assessment of homograft function 1 year after insertion into the pulmonary position: impact of in situ homograft geometry on valve competence
Eur. Heart J., September 1, 2009; 30(17): 2147 - 2154.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J. A. Hawkins, C. T. Sower, L. M. Lambert, P. C. Kouretas, P. T. Burch, A. K. Kaza, M. D. Puchalski, and A. T. Yetman
Stentless porcine valves in the right ventricular outflow tract: improved durability?
Eur. J. Cardiothorac. Surg., April 1, 2009; 35(4): 600 - 605.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
E. J. Hickey, B. W. McCrindle, E. H. Blackstone, T. Yeh Jr., F. Pigula, D. Clarke, C. I. Tchervenkov, J. Hawkins, and the CHSS Pulmonary Conduit Working Group
Jugular venous valved conduit (Contegra(R)) matches allograft performance in infant truncus arteriosus repair
Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 890 - 898.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
W. D. Lu, F. L. Yu, and Z. S. Wu
Superior vena cava reconstruction using bovine jugular vein conduit
Eur. J. Cardiothorac. Surg., November 1, 2007; 32(5): 816 - 817.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
E. Troost, B. Meyns, W. Daenen, F. Van de Werf, M. Gewillig, K. Van Deyk, P. Moons, and W. Budts
Homograft survival after tetralogy of Fallot repair: determinants of accelerated homograft degeneration
Eur. Heart J., October 2, 2007; 28(20): 2503 - 2509.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. Sekarski, H. van Meir, M. E.B. Rijlaarsdam, P. H. Schoof, D. R. Koolbergen, J. Hruda, L. K. von Segesser, E. J. Meijboom, and M. G. Hazekamp
Right Ventricular Outflow Tract Reconstruction With the Bovine Jugular Vein Graft: 5 Years' Experience With 133 Patients
Ann. Thorac. Surg., August 1, 2007; 84(2): 599 - 605.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. Sierra, J. T. Christenson, N. H. Lahlaidi, M. Beghetti, and A. Kalangos
Right Ventricular Outflow Tract Reconstruction: What Conduit to Use? Homograft or Contegra?
Ann. Thorac. Surg., August 1, 2007; 84(2): 606 - 611.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
N. Sinzobahamvya, B. Asfour, M. Boscheinen, J. Photiadis, C. Fink, E. Schindler, V. Hraska, and A. M. Brecher
Compared fate of small-diameter Contegras(R) and homografts in the pulmonary position
Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 209 - 214.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Miyazaki, M. Yamagishi, A. Nakashima, K. Fukae, T. Nakano, H. Yaku, and H. Kado
Expanded polytetrafluoroethylene valved conduit and patch with bulging sinuses in right ventricular outflow tract reconstruction
J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 327 - 332.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Boethig, H. Goerler, M. Westhoff-Bleck, M. Ono, A. Daiber, A. Haverich, and T. Breymann
Evaluation of 188 consecutive homografts implanted in pulmonary position after 20 years
Eur. J. Cardiothorac. Surg., July 1, 2007; 32(1): 133 - 142.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
T. Miyazaki, M. Yamagishi, K. Shuntoh, and H. Yaku
An expanded polytetrafluoroethylene-autologous aortic hybrid valve for right ventricular outflow tract reconstruction in the Ross procedure
Interactive CardioVascular and Thoracic Surgery, April 1, 2007; 6(2): 163 - 166.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. Chiappini, C. Barrea, and J. Rubay
Right Ventricular Outflow Tract Reconstruction With Contegra Monocuspid Transannular Patch in Tetralogy of Fallot
Ann. Thorac. Surg., January 1, 2007; 83(1): 185 - 187.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. J. Rastan, T. Walther, I. Daehnert, J. Hambsch, F. W. Mohr, J. Janousek, and M. Kostelka
Bovine jugular vein conduit for right ventricular outflow tract reconstruction: evaluation of risk factors for mid-term outcome.
Ann. Thorac. Surg., October 1, 2006; 82(4): 1308 - 1315.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. L.S. Morales, B. E. Braud, K. S. Gunter, K. E. Carberry, K. A. Arrington, J. S. Heinle, E. D. McKenzie, and C. D. Fraser Jr
Encouraging results for the Contegra conduit in the problematic right ventricle-to-pulmonary artery connection.
J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 665 - 671.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
L. F. Peng, D. B. McElhinney, A. W. Nugent, A. J. Powell, A. C. Marshall, E. A. Bacha, and J. E. Lock
Endovascular Stenting of Obstructed Right Ventricle-to-Pulmonary Artery Conduits: A 15-Year Experience
Circulation, June 6, 2006; 113(22): 2598 - 2605.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
S. O. Shebani, S. McGuirk, M. Baghai, J. Stickley, J. V. De Giovanni, F. A. Bu'Lock, D. J. Barron, and W. J. Brawn
Right ventricular outflow tract reconstruction using Contegra(R) valved conduit: natural history and conduit performance under pressure
Eur. J. Cardiothorac. Surg., March 1, 2006; 29(3): 397 - 405.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Attmann, T. Jahnke, R. Quaden, A. Boening, S. Muller-Hulsbeck, J. Cremer, and G. Lutter
Advances in Experimental Percutaneous Pulmonary Valve Replacement
Ann. Thorac. Surg., September 1, 2005; 80(3): 969 - 975.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2005 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.