Alternatives to Obtain Right Ventricular to Pulmonary Artery Continuity

Document Type : Original Article

Authors

1 Department of Cardiac Surgery, National Heart Institute, Giza, Egypt

2 Department of Cardiology, National Heart Institute, Giza, Egypt

3 Department of Pediatric Cardiology, National Heart Institute, Giza, Egypt

Abstract

Background: The practice of using valved right ventricular to pulmonary artery (RV-PA) conduit for right ventricular
outflow tract (RVOT) reconstruction was innovated by Ross and Somerville in 1966. The current application of pulmonary
homograft for RVOT reconstruction is the most widely used. Both techniques have limitations for use, especially regarding
availability and occurrence of degenerations. The evolution of Contegra valved conduit had achieved excellent results, but
unfortunately, several studies reported negative feedbacks, which had expressed the limitation of its use.
Aim: Evaluation of the mid-term outcome of RVOT reconstruction using different strategies in a variety of congenital
heart diseases in our institute.
Patients and Methods: A retrospective cohort single center study involving 57 pediatric patients who underwent RVOT
reconstruction surgery between 2010 and 2017 for correction of the following lesions: Ventricular septal defect and
Pulmonary atresia, transposition of great arteries with ventricular septal defect and pulmonary stenosis, truncus arteriosus
and tetralogy of Fallot with absent pulmonary valve. Two groups of comparison were created, group 1 includes 27 patients
who had a handmade non-conduit repair, their mean age was 26.87± 14.03 months, and their mean body weight was
10.48± 3.49 kg. The other 30 patients had bovine jugular vein conduit repair (group 2) and their mean age was 23.17±
10.77 months, where the P value was 0.266. Their mean body weight was 10.35± 2.27; where the P value was 0.868.
Results: Number of cases who needed re-intervention in group 1 was three (11%) and in group 2 was 10 (33%), and the
P value was 0.046. The late mortality in group 1 was four (14.8%) and in group 2 was five (16.7%), and the P value was
0.848.
Conclusion: Ideal RVOT reconstruction technique identification is still a matter of case circumstances, available
resources, and surgeon/ center experience. This promotes the innovations of new techniques for RVOT reconstruction.

Keywords

The Egyptian Journal of Surgery
Volume 44, Issue 2
April 2025
Pages 623-630

Files

Share

How to cite

Statistics