Reconstruction of the right ventricular outflow tract (literature review)

Relevance. For almost six decades, in right ventricular outflow tract reconstruction the choice of a conduit has been and remains a chelleging task for cardiac surgeons. Among the vast number of valve prostheses offered, the choice of its material is still controversial. There are various allografts, xenografts, a combination of Dacron linear prostheses with an implanted locking element made of biological tissue and mechanical materials. Synthetic prostheses with handmade valves made of expanded polytetrafluoroethylene (ePTFE) and bioresorbable tissue-engineered conduits are also being popularized. The constant search for the best conduit is associated with unsatisfactory long-term performance results. The main problem relates to the inevitable biodegradation of the material from which the prosthesis is made. Durability is the main and most important indicator of the quality of conduits.

Aim: To review conduits for right ventricular outflow tract reconstruction based on the analysis of literature data.  

Material and Methods. The research was carried out in the databases Medline (PubMed) and the Russian Science Citation Index (RSCI) using search queries, keywords and logical operators.

Results. According to a systematic literature analysis, the aspects of choosing a conduit for implantation in the pulmonary position were studied. The main complications, immediate and long-term postoperative results were highlighted.

Conclusion. Currently, there is no consensus on the choice of conduit. Quantaty of adult patients previously underwent interventions is increasing. Biodegradation has led to obstruction of the prosthesis, insufficiency of the locking element, or a combination of both situations.

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