Key result
The Contegra conduit for right ventricular outflow tract reconstruction demonstrated an operative mortality of 2.6%, operative morbidity of 13.9%, and an intraconduit stenosis incidence of 10.9%.
Why the study?
Does the Contegra conduit provide safe and effective reconstruction of the right ventricular outflow tract in patients with congenital heart disease?
Systematic Review (n=767)
Does the Contegra conduit provide safe and effective reconstruction of the right ventricular outflow tract in patients with congenital heart disease?
The Contegra conduit shows satisfactory early and mid-term results for right ventricular outflow tract reconstruction, though smaller conduits (12 and 14 mm) are associated with a high rate of stenosis.
Supports Contegra conduit consideration in congenital RVOT reconstruction given low risks; extends pooled evidence but needs long-term follow-up.
OBJECTIVE: The valved conduit Contegra (bovine jugular vein) has being implanted for more than 7 years in the right ventricular outflow tract and it is noted that the available reports have been mixed. The aim of this study is to review the reported evidence in the literature. METHODS: Search of the relevant literature for the primary endpoints of operative mortality and morbidity and secondary endpoints of follow-up haemodynamic performance including severe stenosis, regurgitation and need for reintervention are presented. RESULTS: We selected and analysed 17 series including 767 patients. Commonest indication was Fallot's tetralogy. Operative mortality was 2.6%. Operative morbidity was 13.9%. In follow-up, the incidence of intraconduit stenosis was 10.9% (incidence of stenosis for the 12 millimetre conduit was 83.3% in one series) and that of at least moderate regurgitation was 6.3%.The aspirin users had a stenosis incidence of 10.5% compared to the non-users had a stenosis incidence of 9.6%. CONCLUSION: A dissent on the performance of the Contegra is discussed, while results are satisfactory in the majority of studies apart for the smallest conduits (12 and 14 millimetre), suggesting an association to compromised run-off. The role of aspirin as antithrombotic modulator remains controversial.
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Protopapas et al. (2008) conducted a systematic review in Right ventricular outflow tract (RVOT) reconstruction (n=767). Contegra conduit was evaluated on Operative mortality. The Contegra conduit for right ventricular outflow tract reconstruction demonstrated an operative mortality of 2.6%, operative morbidity of 13.9%, and an intraconduit stenosis incidence of 10.9%.
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