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).