Background: Patients with congenital heart disease (CHD) having hypoplastic or atretic right ventricular outflow tracts (RVOT); such as in transposition of the great arteries with pulmonary stenosis or pulmonary atresia with ventricular septal defect; require right ventricular outflow tract reconstruction, in the form of a right ventricle to pulmonary artery conduit (RV-PA conduit). The most common currently used right ventricle to pulmonary artery conduits (RV-PA) are homografts and bovine jugular vein.

Aim: To use handsewn bovine pericardial conduit with polytetrafluoroethylene (PTFE) membrane leaflets.

Methods: All patients undergoing RV to PA conduits at Children’s Hospital Lahore were included in the study. The conduits used to reconstruct the RVOT were made intra operatively on a back table, using 0.1mm PTFE membrane to construct the valve leaflets and bovine pericardium to make the tube housing the leaflets. The leaflet heights and tube diameter were constructed according to a Z score-based nomogram.

Results: From January 2012 to December 2016, 34 patients received 35 hand sewn conduits of sizes 14 to 22mm. Mean age was 7 years (2 months to 18 years), mean weight was 23kg (9.4 to 53). 10 patients had TGA VSD PS, for which Rastelli operation was done. Nine had aortic valve disease for which Ross operation was performed. On 3 to 5 years follow up only one patient (2.9%) had required surgery for re-stenosis at the conduit.

Conclusion: On short and intermediate term follow up the handmade bovine pericardial tube with PTFE leaflet valve conduit is a functionally comparable, cost effective and reliable alternative to Homografts and Contegra conduits.

Keywords: RV to PA conduit, PTFE valve, bovine pericardium