Morales David L S, Braud Brandi E, Gunter Kathryn S, Carberry Kathleen E, Arrington Karol A, Heinle Jeffrey S, McKenzie E Dean, Fraser Charles D
Division of Congenital Heart Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex 77030, USA.
J Thorac Cardiovasc Surg. 2006 Sep;132(3):665-71. doi: 10.1016/j.jtcvs.2006.03.061.
The Contegra conduit was developed for right ventricular outflow tract reconstruction. This report evaluates the Contegra conduit, with focus on certain subpopulations in which conduits are known to perform poorly (ie, patients with previous homograft conduits and infants).
A retrospective review of 76 patients who had 77 Contegra conduits placed for right ventricular outflow tract reconstruction (January 2001 through August 2005) was completed. Characteristics include the following: median age of 1.6 years (range, 17 days-15.1 years), weight of 9.8 kg (range, 2.5-64.0 kg), and conduit diameter of 16 mm (range, 12-22 mm). Operations performed include right ventricular outflow tract reconstruction for pulmonary atresia-stenosis (n = 33), conduit exchange (n = 28), truncus repair (n = 7), primary conduit placement (n = 6), and the Ross procedure (n = 3). Seventy-nine percent were reoperations.
There was no hospital mortality. Mean follow-up was 20 +/- 14 months. One-, 2-, and 3- year freedom from severe conduit regurgitation was 97%, 86%, and 81%, respectively, and freedom from severe conduit stenosis was 100%. Freedom from reoperation for conduit failure at 1 and 3 years is 98.3% and 93.1%, respectively. All conduit failures (n = 3) were for asymptomatic conduit pseudoaneurysms in the setting of multiple-level pulmonary branch stenoses. Survival at 3 years is 96%. Infants (n = 26) had a freedom from Contegra conduit failure at 3 years of 100%. Patients with previous homograft conduits (n = 26) had a freedom from Contegra conduit failure at 3 years of 100%.
At midterm follow-up, the Contegra conduit remains a reliable, accessible, and easily implantable conduit for right ventricular outflow tract reconstruction. It appears to be the most promising conduit option for patients with previous homograft conduits and for infants.
Contegra管道是为右心室流出道重建而研发的。本报告对Contegra管道进行评估，重点关注已知该管道效果不佳的特定亚组人群（即曾使用同种异体移植管道的患者和婴儿）。
对2001年1月至2005年8月期间76例接受77根Contegra管道进行右心室流出道重建的患者进行回顾性研究。患者特征如下：中位年龄1.6岁（范围17天至15.1岁），体重9.8千克（范围2.5至64.0千克），管道直径16毫米（范围12至22毫米）。实施的手术包括肺动脉闭锁-狭窄的右心室流出道重建（n = 33）、管道置换（n = 28）、动脉干修复（n = 7）、初次管道植入（n = 6）以及Ross手术（n = 3）。79%为再次手术。
无住院死亡病例。平均随访时间为20±14个月。1年、2年和3年无严重管道反流的比例分别为97%、86%和81%，无严重管道狭窄的比例为100%。1年和3年因管道故障再次手术的免手术率分别为98.3%和93.1%。所有管道故障（n = 3）均为在多级肺分支狭窄情况下无症状的管道假性动脉瘤。3年生存率为96%。婴儿（n = 26）3年Contegra管道无故障发生率为100%。曾使用同种异体移植管道的患者（n = 26）3年Contegra管道无故障发生率为100%。
在中期随访中，Contegra管道仍是用于右心室流出道重建的可靠、可及且易于植入的管道。对于曾使用同种异体移植管道的患者和婴儿而言，它似乎是最有前景的管道选择。
