Conduit selection for right ventricular outflow tract reconstruction: contemporary options and outcomes

Reconstruction of the right ventricular outflow tract, with the establishment of an unobstructed pathway between the right ventricle and the pulmonary arteries, is a task that the congenital heart surgeon frequently faces. In situations where this outflow tract is congenitally absent, or the pulmonary valve has been used to replace a dysfunctional left ventricular outflow tract, a conduit is usually required to establish pulmonary blood flow. Cryopreserved homografts are currently favored for this, though these nonviable valved allografts have certain limitations. The following review will further define the problem of right ventricular outflow tract reconstruction, with an emphasis on conduit selection and possible alternatives to conduit repair.