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The Journal of Thoracic and Cardiovascular Surgery, Vol 93, 555-559, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
GK Danielson, TP Downing, HV Schaff, FJ Puga, RM DiDonato and DG Ritter
Tissue-valved prosthetic extracardiac conduits fail in 6% to 30% of
patients within 5 years of implantation. Failure is caused both by valve
degeneration and by conduit peel formation. This report describes a
technique, performed in 16 children, in which an obstructed right
ventricle-to-pulmonary artery valved conduit was removed and a new conduit
constructed using the conduit bed as the posterior wall and a patch of
xenograft pericardium (n = 10), homograft dura mater (n = 5), or Dacron (n
= 1) as the roof of the conduit. One child with pulmonary hypertension
required a Bjork-Shiley pulmonary valve; in the others no valve was
inserted. This technique simplifies conduit replacement, allows for a
generous-sized outflow tract that may grow with patient growth, and uses
material unlikely to become obstructed.
ARTICLES
Replacement of obstructed extracardiac conduits with autogenous tissue reconstructions
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