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October 1, 2011World Journal for Pediatric and Congenital Heart Surgery

Contegra Versus Pulmonary Homografts for Right Ventricular Outflow Tract Reconstruction: A Ten-Year Single-Institution Comparison

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Key result

Bovine jugular vein grafts for RVOT reconstruction demonstrated significantly better freedom from failure, dysfunction, and explantation compared to pulmonary homografts.

Why the study?

Do bovine jugular vein grafts improve graft function and reduce failure compared to pulmonary homografts in patients requiring right ventricular outflow tract reconstruction?

Population

216 patients with congenital heart defects requiring right ventricular outflow tract (RVOT) reconstruction

Comparison

Bovine jugular vein grafts (BJV, Contegra) (n=153) vs Cryopreserved pulmonary homografts (PHs) (n=63)

Design

Cohort

Follow-up

Up to 10 years

Authors

JBJohn W. BrownMRMark RuzmetovMRMark D. Rodefeld

Discussion

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Overview

May support bovine jugular vein grafts for RVOT reconstruction; leaves open need for randomized confirmation.

Study Design

Type

Cohort (n=216)

Multicenter

No

Structured PICO

Do bovine jugular vein grafts improve graft function and reduce failure compared to pulmonary homografts in patients requiring right ventricular outflow tract reconstruction?

P
Population
216 patients with RVOT obstruction who underwent RVOT reconstruction using bovine jugular vein grafts or cryopreserved pulmonary homografts between 1999 and 2010.
E
Exposure
Bovine jugular vein grafts (BJV, Contegra) (n=153)
C
Comparator
Cryopreserved pulmonary homografts (PHs) (n=63)
O
Outcome
Graft dysfunction (RVOT obstruction with peak echo-Doppler gradient >40 mm Hg and/or grade III/IV conduit valve regurgitation) and graft failure (need for conduit replacement or need for catheter or surgical reintervention)composite

Bovine jugular vein grafts provide superior freedom from graft failure and dysfunction compared to pulmonary homografts for right ventricular outflow tract reconstruction.

Limitations

  • Mean follow-up duration was longer in patients that received homografts, which may confound the comparison of conduit dysfunction and failure.
  • Single-institution study
  • Difference in mean follow-up duration between groups

Cite This Study

Brown et al. (2011) conducted a cohort in Right ventricular outflow tract (RVOT) obstruction (n=216). Bovine jugular vein grafts (BJV, Contegra) vs. Cryopreserved pulmonary homografts (PHs) was evaluated on Graft dysfunction, graft failure, and need for explantation. Bovine jugular vein grafts for RVOT reconstruction demonstrated significantly better freedom from failure, dysfunction, and explantation compared to pulmonary homografts.

synapsesocial.com/papers/6a96ce4c0f79e4f014b30bcehttps://doi.org/10.1177/2150135111415711
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras2004 · 158 citations
  2. 2Right ventricular outflow reconstruction with homografts1995 · 9 citations
  3. 3Bovine valved venous xenografts for RVOT reconstruction: results after 71 implantations12002 · 118 citations
  4. 4Bovine Jugular Veins versus Homografts in the Pulmonary Position: An Analysis across Two Centers and 711 Patients—Conventional Comparisons and Time Status Graphs as a New Approach2015 · 41 citations
  5. 5Meta-analysis of valved conduits in right ventricular outflow tract reconstruction: comparison of homograft, bovine jugular vein, and EPTFE valved conduits2026 · 2 citations