[Clinical experinece using tubular grafts in the reconstruction of the right ventricular outflow tract (author's transl)]

Conduit reconstruction of the right ventricular outflow tract is useful in treatment of a variety of congenital cardiac malformations. Seventeen patients underwent conduit reconstruction at the Texas Heart Institute between December 1965 and June 1974. Fifteen patients survived the operation and have significantly improved. Several different conduits were used: allograft aorta with the aortic valve and mitral leaflet attached, a woven Dacron prosthesis containing a prosthetic valve, a prosthesis containing a xenograft (porcine) valve and a valveless Dacron tube graft. Allograft conduits present difficulties with procurement and inventory and tend to calcify with time. Woven Dacron prostheses are favored because of ready availability in a wide range of sizes. In the case of pulmonary hypertension, we use a conduit containing a xenograft (porcine) value. The largest conduit possible must be used. Indications for conduit reconstruction include anomalous coronary arteries, discontinuity between the pulmonary arteries and pulmonary atresia with a VSD. Our current method of management of pulmonary atresia with VSD includes palliative shunt during infancy to permit full development of the pulmonary arteries for total correction at a more optimal age when a larger conduit may be used.