Contegra conduit for reconstruction of the right ventricular outflow tract: a review of published early and mid-time results

Search of the relevant literature for the primary endpoints of operative mortality and morbidity and secondary endpoints of follow-up haemodynamic performance including severe stenosis, regurgitation and need for reintervention are presented.We selected and analysed 17 series including 767 patients. Commonest indication was Fallot's tetralogy. Operative mortality was 2.6%. Operative morbidity was 13.9%. In follow-up, the incidence of intraconduit stenosis was 10.9% (incidence of stenosis for the 12 millimetre conduit was 83.3% in one series) and that of at least moderate regurgitation was 6.3%.The aspirin users had a stenosis incidence of 10.5% compared to the non-users had a stenosis incidence of 9.6%.A dissent on the performance of the Contegra is discussed, while results are satisfactory in the majority of studies apart for the smallest conduits (12 and 14 millimetre), suggesting an association to compromised run-off. The role of aspirin as antithrombotic modulator remains controversial.The refinement of congenital cardiac surgical procedures requiring reconstruction of the right ventricular outflow tract (RVOT) (or substitution for the autograft pulmonary valve in Ross procedure) has led to an increased need for valved conduits, especially for neonates and small infants.The haemodynamic performance and long-term complications of xenograft, composite grafts and homografts have been far from ideal. In view of the rising demand for conduits (especially of small internal diameter) and the decrease in homograft availability, alternative options have been sought.A new solution popularised in Europe and of late in the USA and Canada is a valved conduit xenograft, the Contegra (formerly Venpro, Medtronic Inc, Minneapolis, MN, USA). Derived from bovine jugular vein, it incorporates the native tri-leaflet valve and a natural sinus. The prosthesis is preserved in buffered low concentration glutaraldehyde in order to maintain the leaflet flexibility. Contegra conduits are a