Aortic allografts: reconstruction of right ventricle-pulmonary artery continuity

The use of aortic allografts in the repair of congenital cardiac lesions has increased as a result of both the advent of cryopreservation and the effects of increased donor availability secondary to infant transplantation. During the period 1986 through 1987, 38 cryopreserved aortic allografts were placed for right ventricle-pulmonary artery discontinuity. Size of the allografts ranged from 11 to 26 mm (mean size, 19 mm), and age of the patients ranged from 6 weeks to 26 years (mean age, 5 years). Twenty-one patients had primary placement of aortic allografts, and 17 underwent replacement of previous conduits. There were 5 hospital deaths (13%) overall, only 1 among the 10 patients younger than 6 months of age with truncus arteriosus, and none among the 17 patients having conduit replacement. A large conduit could be placed with a low incidence (10.5%) of postoperative hemorrhage related to the conduit. The aortic allograft is our conduit of choice for both conduit replacement and primary repair of right ventricle-pulmonary artery discontinuity.