Abstract
Introduction. Conduits have been used in cardiovascular surgery for more than 100 years. They are used in neonates and infants in the pulmonary position for the repair of complex congenital heart defects. There are different types of conduits, however, the ongoing search for an “ideal” graft still continues that is due to high incidence of multiple reoperations over patient's lifetime.
Materials and Methods. From January 2006 to February 2013 34 patients underwent right ventricular outflow tract reconstruction using various types of conduits. The age of patients ranged from 14 days to 1 year (4,82 ± 4,09 months), the average body mass was 4,7 ± 2,3 kg (2,9–9,7 kg).
Objective. To present the outcomes of surgery with the use of conduits in the pulmonary position in infants under one year of age. At the same time we aimed to compare the immediate and mid-term results received in other medical centers that deal with this problem.
Results. Totally 5 patients died (the overall mortality rate was 14,7 %). Patients discharged from the hospital were examined with echocardiographic imaging of coronary arteries which showed the mean blood flow velocity in conduit being 2,42 ± 0,72 m/s (ranges from 1,3 to 3,9 m/s), and mean gradient being 22,22 ± 17,17 mm of mercury (ranges from 4 to 60 mm of mercury). 16 reoperations were performed. 3 patients (8,82%) required early reoperations (within one year after the primary intervention), in 2 cases reoperations were performed due to conduit stenosis and one patient developed right ventricular aneurysm.
Conclusions. The choice of conduit for grafting in the pulmonary position remains a serious problem in the treatment of complex congenital heart defects in neonates and infants. The incidence of conduit-related complications doesn't depend on the type of modern grafts used.
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