The biventricular repair of congenital heart diseases with an inadequate or absent ventricle to pulmonary artery connection sometimes requires the use of extracardiac conduits. In order to study the longterm outcome of a glutaraldehyde-preserved bovine pericardial conduit valved with a stentless porcine aortic valve, we reviewed the data of 33 patients operated between November 1985 and October 1995. Patients ages ranged from 15 days to 18 years (mean 5.7 ± 4.3 years). Pulmonary atresia with ventricular septal defect (VSD) was the most frequent disease (16 cases), followed by tetralogy of Fallot with absent pulmonary valve (5), truncus arteriosus (4), transposition of great arteries with VSD and pulmonary stenosis (3) and other miscellaneous (5). The overall hospital mortality was 18.2% and was related to the preoperative clinical condition; 23 patients (70%) were followed by a mean of 4.8 ± 3.0 years (ranging from 3 months to 10 years). The most common late complication observed was stenosis of the anastomosis between the conduit and the pulmonary artery present in 17.4% (4/23) of the patients and was the cause of 2 later reoperations (p=0,02); another patient was reoperated for late conduit endocarditis. This complication was also the cause of 1 of the 4 late deaths (17.4%). The last patient is waiting for surgery. The development of the anastomotic stenosis was problably due to a retraction of the pericardial tissue along the transition with the thin wall of the pulmonary artery. Up to 10 years, gross calcification impairing the function of the valve or the conduit itself could not be detected. In conclusion, the bovine pericardial conduits have shown a good performance as a vascular substitute. Calcification has not been a major drawback. The righ incidence of distal stenosis appears to be more related to a shrinking of the pericardial tissue than to technical reasons.
Vascular prostheses; Bioprostheses; Heart ventricle; Pulmonary artery