Surgical Technique
The conduit was constructed prior to skin incision with a bovine
pericardial sheet (St. Jude Medical, St.Paul, MN) for the tube and 0.1mm
thick e-PTFE (Gore-Tex; W. L. Gore & Assoc., Newark, DE) for the
tri-leaflet valve. The size of BPCTV conduit was +2 Z score of the
pulmonary valve for the body surface area. Three contiguous cusps are
fashioned from a sheet of 0.1mm e-PTFE membrane and sutured to the
smooth side of bovine pericardial sheet. The bovine pericardial sheet is
rolled over a required sizer and its free edges are sutured to create a
valved conduit. (Figure 1,2) The formula used for constructing conduits
of size 12 to 24 is given in table 3. The surgery was performed through
median sternotomy on Cardiopulmonary bypass with moderate hypothermia.
The choice of Cardioplegia was antegrade delivery of DelNido’s solution
at 4 degree C. The distal end of the conduit was sutured to the
pulmonary artery confluence on beating heart in presence of pulmonary
atresia and type 1 Truncus arteriosus. In all other cases, both ends of
the conduit were sutured under cardioplegic arrest.