Abstract book 6th RMS 16.indd

321
Eleven Years Experience with the use
of Contegra ®
Yousef Zureikat MD FRCSI*, Nairooz
Al-Momany, Msc, Zeid Makahleh, FRCS C-Th
* Consultant cardiac Surgeon Queen Alia Heart
Institute King Hussein Medical Centre Royal
medical Services (Jordan)
zmakahleh@yahoo.com
Objectives: The implantation of the Bovine
Jugular Vein (Contegra) in the repair of
many congenital heart defects (CHD) had
gained a world wild acceptance. We report
our experience in using it over eleven years.
Methods: During the period from February
2000- December 2011, we implanted the
Contegra in 268 patients with different
congenital heart defects at the position
ventricle-Pulmonary artery (RV/LV-PA).
There were 178 males and 90 females in
an age ranging between 3 months- 33
years mean of 5.6 yrs. Echocardiography
was performed postoperatively at 3days,
3months, 6months then every year
looking for pressure gradient across the
valve, regurgitation and calcification 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.
Results: The follow up of patients were
100% in 1 yr, 98% in 2 yrs; 82% in 3yrs
and 57% in 4 yrs, 40% in 5yrs, 35% in
6 yrs, 20% continued to show up from
year 7 to year 11. The performance of the
conduit was as follow: Unchanged pressure
gradient or < 15 mmHg over 2yrs in 98%,
PG 15 – 25 mmHg over 3yrs in 25%, PG
25 -35mmHg over 4yrs in 18%, PG 35 –
45mmHg over 5yrs in 14% and by the end
of 11 yrs 10% of pts had PG >55 mmHg
and were scheduled for redo surgery. The
rest of the patients were having minor
changes in the pressure gradients over
variable periods of follow up. There were
no conduit related adverse events, there
were 32 deaths (22 early and 10 late) not
related to conduit implantation.
Conclusion: The Contegra conduit is s a
reliable extra-cardiac conduit for primary
and redo- RVOT reconstruction over eleven
years of follow up
322
A Randomised Trial of Betadine
Wound Irrigation in Varicose Veins
Surgery
Stuart R Walker, HOD, Department of vascular
and Endovascular Surgery, Royal Hobart
Hospital (Australia)
stuart.walker@dhhs.tas.gov.au
Objectives: A meta-analysis suggested that
povidone iodine application to wounds
can reduce the incidence of surgical site
infection (SSI). The aim of this study was
to assess povidone iodine in the groin
wounds of patients undergoing primary
varicose vein surgery.
Methods: A prospective, randomised,
double blind, controlled study in patients
undergoing primary varicose veins surgery.
Patients were randomised to a povidone
iodine (Betadine) soaked surgical gauze
placed in the wound or a saline soaked
gauze placed in the wound. Patients
undergoing bilateral surgery had povidone
iodine in one wound and saline in the other.
Patients were then followed up weekly for
6 weeks by a specialist wound nurse to
observe for signs of wound infection.
Results: 66 legs in 50 patients were
recruited. 36 groin wounds were
randomised to saline and 30 to Betadine.
There was no difference between the
groups with respect to age (49 vs.55
years), maleness (20 vs.15), weight (92 vs.
87 kg), BMI (40 vs. 30), number with active
ulcers (3 vs. 3) and right leg operations
(12 vs.17). There was a reduced incidence
of groin wound infections in those
randomised to Betadine (3 vs.1) but this
was not statistically significant (p = 0.4)
using chi squared test.
Conclusion: Although there may be a trend
towards a lower wound infection rate
when povidone iodine is use in surgical
wounds, this is not significant for varicose
veins surgery. The advent of endovenous
procedures will limit future similar studies
www.jrms.gov.jo
166