Replacement of obstructed extracardiac conduits with autogenous tissue reconstructions
Danielson, G.K.; Downing, T.P.; Schaff, H.V.; Puga, F.J.; DiDonato, R.M.; Ritter, D.G.
Journal of Thoracic and Cardiovascular Surgery 93(4): 555-559
1987
ISSN/ISBN: 0022-5223 PMID: 3561003 Document Number: 302630
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 Björk-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.