Reconstruction of right ventricular outflow tract with monocusp-bearing sinusformed outflow patch

Abstract

A new type of the patch graft for reconstruction of the right ventricular outflow tract in repair of Tetralogy of Fallot is developed and examined in vivo. The design principle is based on the well-known role of the Valsalva sinus on the semilunar valve performance. A semilunar cusp is created with a glutaraldehyde preserved bovine pericardium, and anchored to the dacron velour patch. A concaved structure is formed in the patch graft so as to mimic the natural architecture of the right ventricular outflow tract. The graft is inserted in the outflow portion of the right ventricle in isolated heart-lung preparations, and hemodynamic parameters were assessed. This form of patch graft proved quite effective in relieving the obstruction and in minimizing the regurgitation.