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Ann Thorac Surg 1977;24:223-232
© 1977 The Society of Thoracic Surgeons

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Articles

Experience with Valved Conduits for Repair of Congenital Cardiac Lesions

From the Departments of Cardiovascular Surgery and Cardiology, The Children's Hospital Medical Center, and The Departments of Surgery and Pediatrics, Harvard Medical School, Boston, MA

^* Address reprint requests to Dr. Norwood, Department of Cardiovascular Surgery, The Children's Hospital Medical Center, 300 Longwood Ave, Boston, MA 02115

Dacron valved conduits or aortic allografts were placed between the right heart and the pulmonary artery for repair of various complex congenital cardiac anomalies in 56 patients (aged 15 days to 33 years; median, 11 years). Forty-four patients had a total of 56 previous palliative procedures, which contributed to postoperative morbidity and mortality. Six patients had a total of seven episodes of early or late sepsis involving the conduit. One patient, treated for early sepsis, again developed infection in the Hancock graft 1 year postoperatively and died. Three other patients, 2 with calcified allografts, developed infections 4 months to 7 years following repair and required graft replacement. Hemodynamic data 1 month to 5 years (mean, 1.6 years) following repair revealed mild to moderate obstruction (< 45 mm Hg gradient) at the Hancock conduit valve ring in 13 of 19 patients, while 5 had large pressure gradients (> 75 mm Hg). All aortic allografts had severe obstruction and calcification necessitating graft replacement. It is anticipated that improved technique and appropriate timing of palliative and corrective operations will substantially reduce or eliminate these problems.

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