Arenz C, Sinzobahamvya N, Kaestner M, Blaschczok H C, Photiadis J, Fink C, Schindler E, Asfour B
Pediatric Thoracic and Cardiovascular Surgery, Deutsches Kinderherzzentrum Sankt Augustin, Sankt Augustin, Germany.
Thorac Cardiovasc Surg. 2008 Oct;56(7):401-5. doi: 10.1055/s-2008-1038736. Epub 2008 Sep 22.
Can Contegra grafts withstand high pressure?
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.
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.
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.
康特格拉移植物能承受高压吗？
评估了10例患者在主要主肺动脉侧支动脉（MAPCA）单源化术后植入的康特格拉移植物的功能。修复时的中位年龄为194天，使用了两种导管尺寸：12毫米（n = 8）和14毫米（n = 2）。回顾了超声心动图和心导管检查结果。
2例患者死亡：1例在修复后早期死亡，1例晚期死亡。死亡与移植物无关。幸存者的中位观察时间为31（范围4 - 42）个月。9例患者术后右心室/左心室压力比大于75%。6名幸存者持续存在高压。7例患者接受了19次肺动脉介入扩张/支架置入术。未在导管中检测到阻塞。5例患者的移植物瓣膜反流增加，但从未超过2级（n = 4）。在42个月时，因导管功能障碍/衰竭再次手术的自由度为100%。
在中期随访中，康特格拉移植物能承受高压，无明显功能障碍或需要手术的动脉瘤样扩张。对于婴儿期MAPCA单源化术后使用，康特格拉似乎是主动脉同种异体移植物的可接受替代物。
