RV-PA Conduit Dilation and Stenting
A number of congenital heart lesions, most frequently those in association with pulmonary atresia, are surgically corrected with the use of right ventricle-to-pulmonary artery (RV-PA) conduits. Conduits may be synthetic, or more commonly valved pulmonary, aortic homografts, or bovine jugular grafts. Over time the conduits become calcified, the valves become dysfunctional, and there is resulting stenosis and/or regurgitation. While many centers address conduit stenosis through surgical replacement, transcatheter conduit dilation and/or stenting can delay the need for surgery by several years (1,2). While it is tempting to view the physiology of right ventricular outflow tract obstruction in this situation as analogous to simple valvar pulmonary stenosis (indeed the obstruction is often at the conduit valve), the underlying anatomy and pathophysiology are substantially different and the technical aspects bear little resemblance.
KeywordsPulmonary Atresia Ventricular Outflow Tract Obstruction Conduit Valve Aortic Homograft Underlying Anatomy