Bovine Valved Xenograft in Pulmonary Position: Medium-Term Follow-Up With Excellent Hemodynamics and Freedom From Calcification

O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas

“…The pathological changes were in line with the better performance of the Contegra conduit. A computational fluid dynamic study demonstrated more homogeneous pressure, velocity and shear stress distributions for elliptical compared to circular anastomosis at the pulmonary artery bifurcation, and preferential flow in left pulmonary artery, suggesting that the elliptical anastomosis with larger cross-sectional area than the circular may reduce incidence and degree of distal stenosis, particularly for small size conduits 38 .…”

“…Distal anastomosis stenosis with supravalvular conduit dilation was also found a cause for conduit explanation 14 . Corno et al 38 reported that postoperative intervention was due to twisted or stenotic conduit in 2 of 5 patients. Rastan et al 20 observed that stenosis at the distal anastomosis occurred in 25% of their patients with a mean transconduit gradient increased from 15 to 23 mmHg at follow-up.…”

“…During the follow-up period, conduit valve was absent of regurgitation in 17.2-77.5% 6,9,13 , trivially regurgitant in 31-79.4% 9,13 , mildly regurgitant in 24-58.3% 9,15 , and moderately regurgitant in 3.4-8.6%…”

“…All three patients with a Contegra conduit for total cavopulmonary connection experienced serious complications of conduit thrombosis, implying the thrombogenicity of the Contegra and it was recommended not being used as a conduit for total cavopulmonary connection 38 .…”

“…Conduit plasty was necessary in 6 (0.4%), and reintervention to the conduit or to the pulmonary arteries in 83 (4.9%) patients. The conduit reimplantation was due to severe stenosis (excessive gradient) of the distal anastomosis refractory to interventional treatment 9,14,24,33,35 , (pseudo)aneurysm of the proximal anastomosis 19 , progressive right ventricular dysfunction caused by severe conduit regurgitation 18,20,33 , endocarditis 11,35 or graft degeneration 35 .…”