Repair of Truncus Arteriosus by Bovine Jugular Xenograft in Right Ventricular Outflow Tract

Reduced availability of the homograft makes it very important that one uses alternatives for surgical reconstruction of the right ventricular outflow tract (RVOT) while operating for trunus arteriosus. Bovine jugular venous valved conduit (Contegra) is a bioprosthesis consisting of a glutaraldehyde-preserved bovine jugular vein with a trileaflet venous valve. It is a viable choice in developing countries where the homograft is not freely available. There are studies which have established the safety, usefulness, and durability of Contegra in trunucus repair (1). RVOT reconstruction with a valved RVOT outflow is important in truncus physiology where preoperative pulmonary hypertension mandates that avoidance of pulmonary regurgitation makes the postoperative period smoother. The safety and durability of the Contegra xenograft in other anatomical subsets in addition to truncus arteriosus has been published (2). This video demonstrates the surgical repair of type 1 truncus arteriosus with bovine internal jugular xenograft in RVOT.

References

1. Hickey E, McCrindle BW, Blackstone EH, Yeh, Jr. T, Pigula F, Clarke D, et al. Jugular venous valved conduit (Contegra) matches allograft performance in infant truncus arteriosus repair. Eur J Cardiothorac Surg. 2008;33(5):890-898.
2. Dave H, Mueggler O, Comber M, Enodien B, Nikolaou G, Bauersfeld U, et al. Risk factor analysis of 170 single-institutional Contegra implantations in pulmonary position. Ann Thorac Surg. 2011;91:195–203.

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