RF73 RIGHT VENTRICULAR OUTFLOW TRACT RECONSTRUCTION IN PEDIATRIC CARDIAC SURGERY: FEDERICO II 10-YEARS EXPERIENCE

Abstract

Background and Aim: Surgical repair of congenital heart defects involving reconstruction of the right ventricle outflow tract sometimes requires implantation of a right ventricle to pulmonary artery (RV-PA) conduit. To date, the ideal conduit is yet to be found so different kinds of prosthesis are usually used. It will be presented the 10-years experience with the different PA-RV conduits used at our institution. Methods: From 2007 to 2018, 92 RV-PA conduit implant procedures were performed on 75 children (58 Contegra®, 12 Fresh Homografts and 22 Hancock®). Clinical data were retrospectively collected from medical records and then they were matched for comparison using propensity score. Pediatric Risk of Mortality score, the day of withdrawal of inotropic drugs, the length of the intensive care unit stay and of the hospital stay were used to assess postoperative morbidity. Results: No significant difference was observed when considering the operative data for anesthesia, the intraoperative inotropic support, the perioperative complication rate or the postoperative morbidity and mortality. Length of surgery, of cardiopulmonary bypass, of aortic clamping and the intraoperative and postoperative blood loss was significantly lower in the Homograft group. There were no differences in the reoperation free survival between Contegra® and Hancock® groups but a significantly higher reoperation free survival was observed in Homograft group. Conclusion: RV-PA conduit replacement can be achieved with a low surgical morbidity or mortality with any type of conduit but Homografts seem to be related to a better intraoperative and postoperative outcomes especially due to their long life.