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.