The Clinical Uses of Conduits In Pediatric Cardiac Surgery

Abstract

There are a number of situations in congenital cardiac surgery where a tube-like connection must be established using a conduit. The paradigm is a conduit between the right ventricle and the pulmonary artery bifurcation for tetralogy of Fallot with pulmonary atresia (Kubota et al.,1997) where there is complete failure of development of the main pulmonary artery (fig 1) . Conduits were also a popular method for establishing a connection between the systemic venous circulation and the pulmonary arteries in the early development of the Fontan procedure (Ocello et al., 2007) as well as once again today, and for a time were also placed between the apex of the left ventricle and the descending aorta for complex left ventricular outflow tract obstruction (Zannini et al.,1987). The extracardiac conduit modification of the Fontan operation has re-emerged as a popular option. Many of the conduits used today in congenital cardiac surgery were originally developed for the management of acquired vascular disease, although the earliest clinically applied vascular tube graft was the aortic allograft developed by Robert Gross in Boston for the management of coarctation (Jonas et al., 2014) Introduction 2