Bovine valved jugular vein (Contegra) to reconstruct the right ventricular outflow tract.
The right ventricular outflow tract (RVOT) is the part of the circulation located between the right ventricle and the bifurcation of the pulmonary artery. The most cranial part of the right ventriculum infundibulum, the pulmonary anulus, the valve and finally the main trunk of the pulmonary artery are the most important structures. The RVOT is frequently affected in congenital heart diseases, either isolated, or in combination with other cardiac malformations. Current techniques for surgical correction of anomalies of the RVOT include repair and/or replacement of the pulmonary valve often combined with sub- or supravalvular reconstruction. The use of extracardiac conduits (homografts, stented or stentless xenografts) to re-establish continuity between the pulmonary ventricle and pulmonary artery has been an important advance in repair of complex congenital malformations. The Contegra (Medtronic) conduit was introduced as a xenograft tissue for RVOT reconstruction. This conduit has some advantages over homografts including availability for pediatric and adult patient sizes and proximal and distal cuffs allowing for extended reconstruction. The principal late problem related to extracardiac conduit operations is the inevitable need for one or more conduit replacements due to patient somatic growth or progressive conduit degeneration and calcification leading to stenosis.
Carrel
Thierry
T
Clinic for Cardiovascular Surgery, University Hospital, CH-3010 Bern, Switzerland. thierry.carrel@insel.ch
D001705:Bioprosthesis; D019544:Equipment Failure Analysis; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007601:Jugular Veins / Q000637:transplantation*; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000209:etiology / Q000601:surgery*