Siddiqui Maria Tariq, Hasan Asif, Mohsin Shazia, Hamid Mohammad, Amanullah Muhammad Muneer
Liaquat National Hospital and Medical College, University of Karachi.
J Pak Med Assoc. 2012 Oct;62(10):1113-7.
The focus of this study is to share the experience and outcomes of Contegra graft implantation in the paediatric and adult population in Pakistan.
Between May 2007 and July 2011, 16 patients, underwent implantation of a Contegra valved conduit. All operations were performed through a median sternotomy with cardiopulmonary bypass. Indications included: Pulmonary atresia with ventricular septal defect (n = 11), Tetralogy of Fallot with absent Pulmonary Valve (PV) syndrome (n = 2), double outlet right ventricle, transposition of great arteries and pulmonary stenosis (n = 1), isolated aortic valve disease (n = 1) and a pseudo-aneurysm with infective endocarditis (n = 1).Conduit sizes varied between 16-22 mm.
The three in hospital deaths were unrelated to the Contegra valved conduit. One patient was lost to follow up. Of the 12 survivors, 10 are currently free from re-operation or complications related to the conduit while one needed distal pulmonary artery dilatation owing to critical stenosis and another had severe Valvular regurgitation. Echocardiographic evaluation of the Contegra valved conduit demonstrated no haemodynamically significant valve regurgitation in 10 patients.
In this small review of 16 operations using the Contegra valved conduit for Right Venticular Outflow Tract (RVOT) reconstruction in the paediatric population, we observed good post operative results concerning conduit function. The Contegra conduit provides an excellent substitute to the homograft with satisfactory early and mid-term results though long-term results are awaited in Pakistan.
本研究的重点是分享在巴基斯坦儿科和成人患者中植入Contegra移植物的经验和结果。
2007年5月至2011年7月期间，16例患者接受了Contegra带瓣管道植入术。所有手术均通过正中胸骨切开术并在体外循环下进行。适应症包括：室间隔缺损合并肺动脉闭锁（n = 11）、法洛四联症合并肺动脉瓣缺如综合征（n = 2）、右心室双出口、大动脉转位合并肺动脉狭窄（n = 1）、单纯主动脉瓣疾病（n = 1）以及感染性心内膜炎合并假性动脉瘤（n = 1）。管道尺寸在16 - 22毫米之间。
3例住院死亡与Contegra带瓣管道无关。1例患者失访。在12名幸存者中，10名目前无需因管道相关问题再次手术或出现并发症，1名因严重狭窄需要进行远端肺动脉扩张，另1名有严重瓣膜反流。对Contegra带瓣管道的超声心动图评估显示，10例患者无血流动力学意义上的显著瓣膜反流。
在这项对16例使用Contegra带瓣管道进行小儿右心室流出道（RVOT）重建手术的小型回顾中，我们观察到管道功能方面良好的术后结果。Contegra管道为同种异体移植物提供了出色的替代物，早期和中期结果令人满意，不过在巴基斯坦仍有待长期结果。
