Function of Contegra valved grafts after unifocalization.
BACKGROUND
Can Contegra grafts withstand high pressure?


METHODS
The function of Contegra grafts implanted after unifocalization of major aortopulmonary collateral arteries (MAPCAs) in 10 patients was evaluated. Median age at repair was 194 days and two conduit sizes were used: 12 mm (n = 8) and 14 mm (n = 2). Echocardiography and heart catheterization findings were reviewed.


RESULTS
Two patients died: one early after repair, one late. Death was not graft related. The median duration of observation for survivors was 31 (range 4 - 42) months. The postoperative right ventricular/left ventricular pressure ratio was greater than 75 % in 9 patients. High pressures persisted in 6 survivors. Seven patients underwent interventional dilatation/stenting of pulmonary arteries on 19 occasions. No obstruction was detected in the conduit. Graft valve regurgitation increased in 5 patients, but never exceeded grade 2 (n = 4). Freedom from reoperation for conduit dysfunction/failure was 100 % at month 42.


CONCLUSIONS
At mid-term follow-up, the Contegra grafts withstood high pressure without significant dysfunction or aneurysmal dilatation requiring surgery. Contegra appears to be an acceptable alternative to the aortic homograft for use after unifocalization of MAPCAs in infancy.
Arenz
C
C
Pediatric Thoracic and Cardiovascular Surgery, Deutsches Kinderherzzentrum Sankt Augustin, Sankt Augustin, Germany.
Sinzobahamvya
N
N
Kaestner
M
M
Blaschczok
H C
HC
Photiadis
J
J
Fink
C
C
Schindler
E
E
Asfour
B
B
D000714:Anastomosis, Surgical; D000818:Animals; D001705:Bioprosthesis; D001794:Blood Pressure; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D002417:Cattle; D002675:Child, Preschool; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007223:Infant; D007601:Jugular Veins / Q000637:transplantation*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome; D017725:Ventricular Pressure