The Journal of Thoracic and Cardiovascular Surgery, Vol 71, 11-19, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Reconstruction of right ventricular outflow tract with a valved conduit in 75 cases of congenital heart disease
CH Moore, V Martelli and DN Ross
Reconstruction of the right ventricular outflow tract with an aortic
homograft conduit was performed in 75 patients from 1966 to 1974. The types
of congenital heart disease were as follows: pulmonary atresia, 35 cases;
severe tetralogy of Fallot, 22 cases; truncus arteriosus, 6 cases;
transposition of the great arteries (TGA), 3 cases; single ventricle, 2
cases; and tricuspid atresia, 7 cases. Ninety per cent of the patients had
one or more previous shunts, and this was a factor affecting the mortality
rate. Other factors included age, pulmonary vascular resistance, surgical
anatomy, and technical problems such as bleeding, prolonged bypass,
coronary artery injury, and compression of the conduit by the sternum. Our
present approach is to avoid shunts, define the anatomy precisely by
angiography, and to attempt total correction when severe hypoxia or effort
intolerance occurs or before increased pulmonary vascular resistance
develops.
