Short and intermediate Term Outcome Post Right Ventricle to Pulmonary Artery Conduit Surgery

Abstract

Reconstruction of RV to PA continuity is a principal part of various surgical procedures commonly performed in neonates and young infants to repair congenital heart disease (CHD). Inspite of our initial success in treating those complex patients, this part of the repair seems to be the ‘‘gift that keeps on giving,’’ and RV to PA reinterventions, both surgical and catheter based, have rapidly become among the most common procedures performed in children, as well as adults, with congenital heart disease. The ideal RV to PA conduit has been extensively searched for, and it goes without saying that a perfect RV to PA conduit does not exist. Several factors that influence RV to PA conduit re intervention risk have been identified, these include the patient’s age and weight, the underlying anatomy, the quality of the branch pulmonary arteries, and of course conduit type and size. Over the years, different types of conduits were developed; among them valved conduits, which can be divided mainly into three categories: (i) homograft (pulmonary and aortic); (ii) stented xenograft; and (iii) stentless xenograft conduits. Cryo preserved homografts are preferred to irradiate homografts, chemically sterilized, and fresh antibiotic-sterilized, the latter three showed alterations in biological characteristics observed shortly after implantation.