Introduction
Restoration of right ventricle (RV) to pulmonary artery (PA) continuity is an essential component of surgical procedures performed for many congenital heart defects. In addition to the primary procedure, the patient will undergo multiple re-operations for revision of the RV to PA conduit. The cumulative cost of therapy may become substantial in the first decade of patient’s life and is comparable to that of patients with single ventricle physiology. (1,2) The considerable resource utilisation for this group of patients can be prohibitive in low and middle income countries (LMICs).
An ideal RV to PA conduit should be easily available, durable, offer resistance to infection, prevent thrombosis and able to grow with the child. Although an ideal conduit does not exist, several options are available. As stated previously, commercially available conduits are expensive and can exponentially increase the cost of surgery in low and middle income countries. Homograft valve banks are resource intensive to maintain and as a result most paediatric cardiac programs in LMICs do not have access to homografts. These factors have renewed the interest in hand sewn conduits. Recent evidence has shown that the hand sewn conduits implanted in RV to PA position have an acceptable clinical outcome which compares favourably with the commercially available conduits. (3) We present a single centre experience with forty one patients who underwent for RV-PA conduit implantation using bovine pericardial conduit with tri-leaflet valve (BPCTV).