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Fig 2. This figure demonstrates the placement of an aortic homograft from the right ventricle to the right pulmonary artery (RPA). (A) A longitudinal incision is made in the right ventricle and the superior vena cava is retracted medially to expose the right pulmonary artery where a longitudinal pulmonary arteriotomy was made. (B) An aortic homograft may be used because it is more pliable and has a slight curve that allows for a more natural position when in place. A small piece of Dacron graft was used as a proximal extension from the right ventricle to the aortic homograft. In patients with mediastinal fibrosis, the right ventricle is generally not grossly enlarged or hypertrophied, which allows for easier conduit placement between the right ventricle and sternum.
