Document Detail


Bovine valved xenograft in pulmonary position: medium-term follow-up with excellent hemodynamics and freedom from calcification.
MedLine Citation:
PMID:  15464502     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study was designed to evaluate the outcome of Contegra xenograft valved conduit (Contegra, Medtronic Inc, Minneapolis, MN). METHODS: From April 1999 to December 2003, 67 patients with a mean age of 16.1 +/-15.0 years (2 months to 53 years) and a mean weight of 39.7 +/- 27.1 kg (4 to 95 kg) were discharged after implantation of a Contegra conduit. The diagnosis contained the following: pulmonary valve replacement during Ross operation (n = 27), pulmonary valve regurgitation (n = 9), tetralogy of Fallot (n = 7), pulmonary atresia with ventricular septal defect (n = 7), double outlet right ventricle (n = 7), truncus arteriosus (n = 5), Taussig-Bing (n = 2), obstructed conduit (n = 2), and double discordance (n = 1). Conduit size was 14 mm in 2, 16 mm in 7, 18 mm in 12, 20 mm in 13, and 22 mm in 33 patients. Mean cardiopulmonary bypass was 155 +/- 48 min (65 to 337 min) and mean aortic cross clamping was 69 +/- 38 min (0 to 146 min). All patients underwent echocardiography, 23 of 67 (34%) patients had cardiac catheterization, and 23 of 67 (34%) patients had electrocardiograph-gated multislice computer tomography. RESULTS: In a mean follow-up of 26.4 months (1 to 56 months) there was one late death (1 of 67 patients; 1.5% mortality) unrelated to the conduit. Five patients underwent reoperation; four were nonconduit-related and one was to replace a twisted conduit. Five patients underwent interventional cardiology; three were nonconduit-related and two were to stent a twisted or stenotic conduit. Echocardiography showed absent valve regurgitation in 30 of 67 (45%) patients, trivial in 21 of 67 (31%) patients, mild in 16 of 67 (24%) patients. The transconduit pressure gradient remained stable during follow-up, with peak pressure gradient 17 +/- 11 mm Hg and mean gradient 8 +/- 6 mm Hg. Internal diameters corresponded to 110% +/- 20% of the implanted diameter at level of proximal anastomosis, 112% +/- 18% at valve level, and 110% +/- 14% at distal anastomosis. Calcifications were not found, with the exception of a minimal (2.3 mm) parietal calcification. CONCLUSIONS: The Contegra valved conduit provided excellent morphology and hemodynamics, and freedom from calcification in a medium-term follow-up.
Authors:
Antonio F Corno; Salah D Qanadli; Nicole Sekarski; Simona Artemisia; Michel Hurni; Piergiorgio Tozzi; Ludwig K von Segesser
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  78     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-06     Completed Date:  2005-06-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1382-8; discussion 1382-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. antonio.corno@chuv.hospvd.ch
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Animals
Bioprosthesis*
Calcinosis
Cattle
Child
Child, Preschool
Electrocardiography
Female
Follow-Up Studies
Heart Defects, Congenital / surgery
Heart Valve Diseases / surgery,  ultrasonography
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / statistics & numerical data
Heart Ventricles / surgery
Hemodynamics*
Humans
Imaging, Three-Dimensional
Infant
Jugular Veins / transplantation*,  ultrastructure
Male
Middle Aged
Postoperative Complications
Pulmonary Valve / abnormalities,  surgery*
Reoperation
Stents
Tomography, X-Ray Computed
Transplantation, Heterotopic
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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