Hand-sewn Valved Decellularised Bovine Pericardial Conduit for Right Ventricular Outflow Tract Reconstruction- Early Experience

Ravi Agarwal, Swaminathan Vaidyanathan, Roy Varghese

The Madras Medical Mission, Chennai, India

Date, time and location: 2018.05.25 15:30, Press Hall, 2F

Abstract

Objective

Right ventricle to pulmonary artery conduit is an essential part of treatment for some congenital heart diseases. An ideal conduit should be easily available in all sizes, should be cost effective and should have potential to grow with the baby. There are some reports that decellularized bovine pericardium may have growth potential due to re population by the host cells. This study reviews our experience with implantation of hand-sewn valved conduits made out of decellularized bovine pericardium for right ventricular outflow tract reconstruction.

Methods

25 patients underwent right ventricle to pulmonary artery reconstruction using hand-sewn decellularized bovine pericardial conduits. We analyzed the preoperative characteristics, intra-operative details and short term results including mortality.

Results

Mean age of the patients was 45.9±74.6 months(Range: 1-312). Mean weight was 11.6±11.2 Kg(Range: 3.7-51.2) and mean body surface area was 0.49±0.31 M² (Range: 0.23-1.54).Mean expected pulmonary artery size with respect to body surface area was 11.4±2.3 mm (Range: 8.4-17.6). Mean implanted conduit size was 14.1±2.0 mm (Range: 12-18). Mean CPB time was 235±62 minutes (Range: 88-360) and aortic cross clamp time was 125±45 minutes (Range: 44-229). There was no mortality in the immediate postoperative period or follow up. There was no incidence of conduit thrombosis, conduit dilatation or endocarditis. Four (16%) patients had mild conduit regurgitation in the follow up echo. One patient (4%) required branch pulmonary artery stenting in the post operative period and one child has shown moderate conduit gradient after 3 months follow up

Conclusion

Hand sewn decellularized bovine pericardial conduits used for right ventricular outflow tract reconstruction provide effective palliation with good short term conduit function. They have excellent tissue handling characteristics and can be prepared easily in small sizes. Longer follow up is needed to establish the perceived growth potential.