Right ventricular outflow tract reconstruction using Contegra® conduit in Tetralogy of Fallot: Single centre experience

Background: Right Ventricular Outflow Tract {RVOT} reconstruction using a conduit may be used in Tetralogy of Fallot patients who would otherwise require a trans-annular patch with the advantages of avoidance of free pulmonary regurgitation with its deleterious short and long term effects. Whereas an ideal conduit remains undefined, Contegra® bovine jugular vein bioprosthesis has been increasingly favored for this purpose worldwide. Present study summarizes the early and midterm outcome of Contegra bioprosthesis in RVOT reconstruction in patients of Tetralogy of Fallot (TOF). Methods: Between Jan 2000 to April 2009, 34 patients of TOF required conduit reconstruction of RVOT using Contegra at our centre. Hospital records of these patients were retrospectively reviewed. Results: Patients were in the age range of 2 to 20 years [mean age 3.2 years] and weighing between 12 to 57 kg [mean weight 15 kg]. There were two early and no late deaths at a mean follow up of 23 months [range 6-110 months]. There were no reintervention or reoperations. All patients had trans-thoracic echo before leaving hospital with a mean pulmonary valve pressure gradient of 11.7 ± 6.1 mmHg. During the whole follow-up, there was no pressure gradient detectable across the conduit valve in 15 patients (44%). The maximal transvalvular peak gradients of 22-28 mmHg were measured in 3 patients (8%). Also, there was no valvular incompetence at all detectable in 20 patients (58%). Grade 1 regurgitation was seen in 10 patients (29%). Conclusions: The Contegra bovine xenograft offers many advantages. It is suitable for patients of all age groups and is technically simple and safe to implant and provides excellent midterm hemodynamic results. © 2010 Indian Association of Cardiovascular-Thoracic Surgeons.