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. 2020 Sep 1:58:107-111.
doi: 10.1016/j.amsu.2020.08.023. eCollection 2020 Oct.

Right ventricular outflow reconstruction with handmade valve conduit - A short experience from a developing country. Case series

Yasir Khan  1 , Syed Shahabuddin  1 , Muneer Amanullah  1
Affiliations

Right ventricular outflow reconstruction with handmade valve conduit - A short experience from a developing country. Case series

Yasir Khan et al. Ann Med Surg (Lond). .

Abstract

Objectives: Right ventricular outflow tract continuity abnormalities are one of the most commonly encountered entities in the field of congenital cardiac surgery. Various strategies including homograft, valve conduit, Contegra are used to restore continuity between right ventricle and pulmonary artery. In countries like Pakistan these may not be easily available and affordable. We report the experience of our short observational study of using a handmade trileaflet valve conduit to reconstruct the right ventricular outflow tract.

Methodology: From September 2015 to December 2016, a total of 15 patients with different congenital heart diseases underwent open-heart surgery at our institute. Restoration of right ventricular to pulmonary artery continuity was achieved using handmade valve conduit utilizing bovine pericardium and thin sheet PTFE sheets (0.1 mm) as conduit and valve respectively.

Results: Patients ranged from 1 to 16 years. Seven patients had previous palliation including 4 blalock taussig (BT) Shunts and 3 pulmonary artery (PA) banding. Postoperative complications were observed in 4 patient including 2 in hospital deaths and 2 required interventions. One patient developed aneurysm at RV- conduit junction requiring surgical repair and the other underwent conduit dilatation for moderate to severe stenosis (gradient 60 mmHg). No significant regurgitation was observed in this series. Overall postoperative gradients were stable with mean gradient 25.3 mmHg (8 mmhg - 60 mmHg).

Conclusion: The use of handmade valve conduits has acceptable morbidity and mortality. These are cost effective alternatives in this part of the world, where well-established conduits have cost implications and uncertain availability.

Keywords: Cost effective; Developing country; Handmade valve conduit.

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Figures

Fig. 1
Fig. 1
Shows constructed PTFE valve inside Bovine pericardium conduit.
Fig. 2
Fig. 2
Intraoperative picture of right ventricular outflow tract reconstruction with handmade valve conduit.
See this image and copyright information in PMC

References

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