Risk Factors for Infective Endocarditis in Contegra Grafts Used as Right Ventricle-Pulmonary Artery Conduits: A Retrospective Cohort Study.

Infective endocarditis developed in 6.3% of patients following Contegra implantation for RVOT reconstruction.

• 13 of 206 patients (6.3%) developed IE during a median Contegra indwelling duration of 43.0 months.
• IE occurred at a median of 27.1 months after implantation.
• Three-year freedom from IE was 94.4%.
• The annualized incidence was 1.8% (1.8 cases per 100 patient-years).

Gram-positive cocci were the most common pathogens causing Contegra IE.

• Gram-positive cocci accounted for 11 of 13 IE cases (84.6%).
• There was one in-hospital death due to fungal IE.
• The study period was 2016 to 2023.

Higher postoperative conduit peak flow velocity was the only identified risk factor for IE.

• Hazard ratio was 4.01 per 1 m/s increase in conduit peak flow velocity (95% CI, 1.31–12.27; P = .015).
• Risk factors were assessed using Cox regression.
• A cutoff of 1.45 m/s predicted IE with a sensitivity of 84% and specificity of 51% (AUC, 0.67).

The majority of infected Contegra conduits required surgical replacement, most often during active infection.

• Infected conduits were surgically replaced in 11 of 13 patients (84.6%).
• Replacement was performed during active infection in 8 patients and after resolution in 3 patients.

The study cohort was composed predominantly of young, small patients undergoing Contegra implantation as a first conduit.

• 206 total patients underwent Contegra implantation for RVOT reconstruction between 2016 and 2023.
• Contegra was used as the first conduit in 161 patients.
• Median age at operation was 10.8 months and median weight was 8.5 kg.
• The median diameter of Contegra implanted was 14 mm.