Follow-up of patients with right ventricle-pulmonary artery conduits.

Between 1981 and 1998, 77 right ventricle-pulmonary artery conduits were im planted in 67 patients (37 boys, 30 girls, average age 6.3 years; range : 3 months to 17 years). The diagnoses were transposition of the great arterie s with ventricular septal defect and obstruction of the pulmonary outflow t ract (N= 22), tetralogy of Fallot (N= 16), truncus arteriosus (N= 9), doubl e outlet right ventricle with pulmonary stenosis or atresia (N= 8) and agen esis of the pulmonary valve with pulmonary stenosis (N= 2). The implanted c onduits were homografts in 50 cases (43 aortic and 7 pulmonary), 11 valved Dacron grafts, 4 valved polystans grafts and 2 non-valved conduits. The average follow-up period was 3.6 years (range : 1 month to 17 years). E arly death was observed in 8 patients (12%) and late death in 6 patients (9 %). The 5, 10 and 15 year survival rates were 78.4%, 65.3%, and 65.3%, resp ectively. The conduits had to be replaced in 10 patients (15%). The non-rep lacement rate of all conduits at 5, 10 and 15 years was 81.4%; 40.7% and 40 .7%, respectively, The causes of replacement were pure stenosis (54.5%), pu re regurgitation (9%) and mixed stenosis and regurgitation (27.2%). These results are comparable to other published series showing a 15 year su rvival rate of 65% and a 59% reoperation rate at 15 years. Homografts have a slightly longer life compared with valved Dacron conduits but the differe nce is not statistically significant.