Alternatives to Obtain Right Ventricular to Pulmonary Artery Continuity

Background: The practice of using valved right ventricular to pulmonary artery (RV-PA) conduit for right ventricularoutflow tract (RVOT) reconstruction was innovated by Ross and Somerville in 1966. The current application of pulmonaryhomograft for RVOT reconstruction is the most widely used. Both techniques have limitations for use, especially regardingavailability and occurrence of degenerations. The evolution of Contegra valved conduit had achieved excellent results, butunfortunately, 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 congenitalheart diseases in our institute.Patients and Methods: A retrospective cohort single center study involving 57 pediatric patients who underwent RVOTreconstruction surgery between 2010 and 2017 for correction of the following lesions: Ventricular septal defect andPulmonary atresia, transposition of great arteries with ventricular septal defect and pulmonary stenosis, truncus arteriosusand tetralogy of Fallot with absent pulmonary valve. Two groups of comparison were created, group 1 includes 27 patientswho had a handmade non-conduit repair, their mean age was 26.87± 14.03 months, and their mean body weight was10.48± 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 theP 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 was0.848.Conclusion: Ideal RVOT reconstruction technique identification is still a matter of case circumstances, availableresources, and surgeon/ center experience. This promotes the innovations of new techniques for RVOT reconstruction.