Durability of Right Ventricle to Pulmonary Artery Conduits Implanted in Patients Less Than One Year of Age

Objectives

Neonates and infants with conotruncal heart defects often require placement of valved conduits to establish continuity between the right ventricle (RV) and pulmonary arteries (PA). The objective of this study was to assess the function and reintervention profile of RV-PA conduits implanted in patients who are less than 1 year of age.

Methods

Ninety-one infants underwent placement of an RV-PA conduit at a single institution between 2012 and 2023. Patient records and imaging were reviewed for demographics, operative characteristics, and postoperative outcomes.

Results

The median age and weight at the time of index RV-PA conduit were 15 (IQR 6-174) days and 3.6 (IQR 3.0-6.5) kg. The median conduit diameter was 10 (IQR 9-12) mm, and the most common conduit was a pulmonary homograft (45%, 41/91). There were no mortalities at the index operation. Median follow-up was 5.8 (IQR 2.8-9) years.

All patients in the cohort have undergone at least 1 conduit replacement at a median interval of 27.2 (IQR 10.1-53.2) months, with 24% of those patients (22/91) being less than 1 year of age at first replacement. There were 7 deaths following the first reoperation over a median follow-up of 14.2 (0.6-59.5) months, and 86% (6/7) of those who died were less than 1 year of age at the time of conduit replacement.

Conclusions

These results benchmark contemporary outcomes of right ventricle to pulmonary artery conduit durability in neonates and infants. There is significant morbidity and mortality associated with reoperation for conduit replacement at less than 1 year of age.