Alternatives to Obtain Right Ventricular to Pulmonary Artery Continuity | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 44, Issue 2, April 2025, Page 623-630 PDF (651.52 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2024.327317.1235 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Ahmed Algebaly  1; Ahmed Meawad2; Rania AbuShokka2; Hanan M. Hassan3
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| 1Department of Cardiac Surgery, National Heart Institute, Giza, Egypt | ||||
| 2Department of Cardiology, National Heart Institute, Giza, Egypt | ||||
| 3Department 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 | ||||
| Artery continuity; contegra; right ventricular outflow tract reconstruction | ||||
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