Related Experiment Video
Updated: Aug 11, 2026
Establishment and Confirmation of a Postnatal Right Ventricular Volume Overload Mouse Model
Published on: June 9, 2023
Durability of Right Ventricle to Pulmonary Artery Conduits Implanted in Patients Less Than One Year of Age
James M Meza1, John D Cleveland1, Jason Greenberg1
1Division of Cardiothoracic Surgery, Heart Institute, Children's Hospital of Los Angeles, Los Angeles, CA, USA.
Insights
Infants with conotruncal heart defects need right ventricle to pulmonary artery (RV-PA) conduits. All infants required reoperation, with significant morbidity and mortality in those under one year old undergoing reoperation.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease
- Cardiovascular Surgery
Background:
- Neonates and infants with conotruncal heart defects often require valved conduits for right ventricle (RV) to pulmonary artery (PA) reconstruction.
- Assessing the long-term function and reintervention rates of these conduits in young children is crucial for surgical planning and patient outcomes.
Purpose of the Study:
- To evaluate the durability and reintervention profile of RV-PA conduits implanted in patients less than one year of age.
- To identify factors associated with conduit failure and reoperation in this vulnerable population.
Main Methods:
- A retrospective review of 91 infants who underwent RV-PA conduit placement between 2012 and 2023.
- Analysis of patient demographics, operative characteristics, and postoperative outcomes including reoperation rates and mortality.
Main Results:
- The median age at conduit placement was 15 days; pulmonary homografts were most common (45%).
- All patients required at least one conduit replacement, with 24% needing it before age one.
- Mortality was associated with reoperation, particularly in infants under one year old at the time of replacement.
Conclusions:
- Contemporary RV-PA conduits in neonates and infants demonstrate limited durability, necessitating frequent reinterventions.
- Reoperation for conduit replacement in infants under one year of age is associated with significant morbidity and mortality.
Abstract:
ObjectivesNeonates and infants with conotruncal heart defects often require placement of valved conduits to establish continuity between the right ventricle (RV) and pulmonary arteries (PA). The objective of this study was to assess the function and reintervention profile of RV-PA conduits implanted in patients who are less than 1 year of age.MethodsNinety-one infants underwent placement of an RV-PA conduit at a single institution between 2012 and 2023. Patient records and imaging were reviewed for demographics, operative characteristics, and postoperative outcomes.ResultsThe median age and weight at the time of index RV-PA conduit were 15 (IQR 6-174) days and 3.6 (IQR 3.0-6.5) kg. The median conduit diameter was 10 (IQR 9-12) mm, and the most common conduit was a pulmonary homograft (45%, 41/91). There were no mortalities at the index operation. Median follow-up was 5.8 (IQR 2.8-9) years.All patients in the cohort have undergone at least 1 conduit replacement at a median interval of 27.2 (IQR 10.1-53.2) months, with 24% of those patients (22/91) being less than 1 year of age at first replacement. There were 7 deaths following the first reoperation over a median follow-up of 14.2 (0.6-59.5) months, and 86% (6/7) of those who died were less than 1 year of age at the time of conduit replacement.ConclusionsThese results benchmark contemporary outcomes of right ventricle to pulmonary artery conduit durability in neonates and infants. There is significant morbidity and mortality associated with reoperation for conduit replacement at less than 1 year of age.
