Risk Factors for Early Adverse Outcomes After Bovine Jugular Vein Conduit Implantation: Influence of Oversized Conduit on the Outcomes

Overview

Journal Interact Cardiovasc Thorac Surg

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2022 Jul 27

PMID 35894797

Authors

Dong-Hee Kim

Young Kern Kwon

Eun Seok Choi

Bo Sang Kwon

Chun Soo Park

Tae-Jin Yun

Affiliations

Soon will be listed here.

Abstract

Objectives: We investigated potential risk factors for early failure of bovine jugular vein conduit (Contegra®) implantation for right ventricular outflow tract (RVOT) reconstruction.

Methods: A single-centre retrospective review of 115 consecutive patients (54 males) who underwent RVOT reconstruction with Contegra between 2016 and 2019 was performed. Overall survival, explantation-free survival and freedom from significant RVOT lesions (valve regurgitation ≥ moderate or flow velocity ≥3.5 m/s) were investigated.

Results: Median age, body weight and Contegra diameter were 10.3 months [interquartile range (IQR) 5.7-26.9 months], 7.8 kg (IQR 6.3-12.4 kg) and 14 mm (IQR 12-16 mm), respectively. During the median follow-up duration of 25.1 months, there were 7 deaths, 34 significant RVOT lesions, 10 endocarditis episodes and 15 explantations. Overall survival and explantation-free survival at 3 years were 94.8% and 78.4%, respectively. Significant RVOT lesions (n = 34) comprised 20 stenoses, 8 regurgitations and 6 combined lesions. Freedom from significant RVOT lesions at 3 years was 62.6%. Cox regression identified higher indexed Contegra size (Contegra diameter/body weight, mm/kg) as the only risk factor for decreased time to explantation or death (hazard ratio 2.32, P < 0.001) and time to significant RVOT lesions development (hazard ratio 2.75, P < 0.001). The cut-off value of indexed Contegra size for significant RVOT lesions at 12 months was 1.905 mm/kg (sensitivity, 0.75; specificity, 0.78; area under the curve, 0.82).

Conclusions: Outcomes of RVOT reconstruction using Contegra were acceptable. However, oversized Contegra should be avoided when possible.

Irb Approval Date: 26 October 2020.

Irb Registration Number: S2020-2505-0001.

Citing Articles

Outcomes after Biventricular Repair Using a Conduit between the Right Ventricle and Pulmonary Artery in Infancy.

Jang D, Kim D, Choi E, Yun T, Park C J Chest Surg. 2024; 57(1):70-78.

PMID: 38174893 PMC: 10792375. DOI: 10.5090/jcs.23.107.

Medium-term outcomes of bovine jugular valved conduits for right ventricular outflow tract reconstruction in children: a retrospective cohort study from China.

Hao S, Zou M, Cao F, Chen W, Liu J, Ma L Transl Pediatr. 2023; 12(10):1842-1852.

PMID: 37969123 PMC: 10644029. DOI: 10.21037/tp-23-287.

Past, present, and future options for right ventricular outflow tract reconstruction.

Carrel T Front Surg. 2023; 10:1185324.

PMID: 37334202 PMC: 10272445. DOI: 10.3389/fsurg.2023.1185324.

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