Pressure load-sensing assessments of the right ventricular outflow tract and main pulmonary artery

Surgical repairs for congenital right ventricular outflow tract disease have commonly required multiple procedures because of hemodynamic failures from previous operations. Over the past decade, the percutaneous placement of stented valve prostheses in a failed right ventricular outflow tract conduit to restore acceptable pulmonary valve function has produced acceptable results; however, the incidence of stent fractures post-implantation in these stented valve prostheses has aroused concerns. In order to investigate this problem, sequential, pressure load-sensing assessments throughout the right ventricular outflow tract and into the main pulmonary artery would be required to effectively evaluate the degree of physiological loading along these sites. Customarily, to perform these assessments, multiple cardiopulmonary bypass procedures, as well as multiple pulmonary arteriotomies would be required, both of which carry their own risks. Owing to these risks, we developed a successful surgical technique for sequential load-sensing evaluations throughout the right ventricular outflow tract and main pulmonary artery using a single cardiopulmonary bypass session and one pulmonary arteriotomy. This technique successfully provided a means to prevent multiple arteriotomies and bypass sessions without complications while obtaining reproducible data in evaluating pressure load-sensing states throughout the right ventricular outflow tract and main pulmonary artery in adult sheep.