The Faith of Small Contegra®-Grafts in RVOT

  • Prof Boulos Asfour, Congenital Cardiac Center, Dpt. of Cardiac Surgery, 53757 Sankt Augustin, Germany, Germany
  • Dr Nicodeme Sinzobahamvya, Congenital Cardiac Center, Dpt. of Cardiac Surgery, 53757 Sankt Augustin, Germany, Germany
  • Dr Christoph Haun, Congenital Cardiac Center, Dpt. of Intensive Care Medicine, 53757 Sankt Augustin, Germany, Germany
  • Dr Martin Schneider, Congenital Cardiac Center, Dpt. of Cardiology, 53757 Sankt Augustin, Germany, Germany
  • Dr Ehrenfried Schindler, Congenital Cardiac Center, Dpt. of Anesthesiology, 53757 Sankt Augustin, Germany, Germany
  • Prof Victor Hraska, Congenital Cardiac Center, Dpt. of Cardiac Surgery, 53757 Sankt Augustin, Germany, Germany

    • Background: Early conduit failure is typically seen in small sized grafts used for reconstruction of RVOT. We analyzed the freedom from explantation and catheter-reintervention of small Contegra®-grafts (CG) in relation to the underlying malformation.
    Methods: Between 10/2002 and 12/2007 37 patients (pts.) underwent reconstruction of RVOT with either 12 mm CG (29 pts.) or 14 mm CG (8 pts.). Pts were divided in three groups: group I: PA/VSD/MAPCA – suboptimal pulmonary artery architecture (n=13); group II: truncus arteriosus (TAC) (n=11); groupIII others (n=13). Mean age at operation was 136 days (5-780).
    Results: At the mean FU of 26 months, overall survival rate was 86%, and 81% at one and two years of FU respectively. Deaths were not conduit related. Six grafts were explanted due to failure. Freedom from CG redo was 87% and 82% at 12 and 24 months of FU with no differences among groups. No catheter interventios were needed for CG but pulmonary artery stenosis. At 24 months of FU, freedom from catheter-intervention was 22%, 39% , 80% in I (p=0.01), II and III group respectively.
    Conclusion: Longevity of small Contegra®-grafts is not effected either by the underlying diseases or small pulmonary arteries (group I). Therefore the use of small CG seems to be justified even for pts with suboptimal pulmonary artery architecture.