IMR Press / RCM / Volume 23 / Issue 3 / DOI: 10.31083/j.rcm2303085
Open Access Original Research
Individualized right ventricular outflow tract reconstruction using autologous pulmonary tissue in situ for the treatment of pulmonary atresia with ventricular septum defect
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1 Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, 410011 Changsha, Hunan, China
2 Department of the Cardiovascular Surgery, Hunan Provincial People's Hospital, 410005 Changsha, Hunan, China
3 Department of Cardiothoracic Surgery, Hunan Children's Hospital, 410007 Changsha, Hunan, China
*Correspondence: (Chengming Fan); (Jinfu Yang)
Academic Editor: Jinnette D. Abbott
Rev. Cardiovasc. Med. 2022, 23(3), 85;
Submitted: 9 November 2021 | Revised: 10 December 2021 | Accepted: 20 December 2021 | Published: 4 March 2022
(This article belongs to the Special Issue Structural Heart Interventions)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Objective: The study aims to evaluate the feasibility and effectiveness of an individualized procedure for right ventricular outflow tract (RVOT) reconstruction in pulmonary atresia with ventricular septal defect (PA-VSD). Methods: RVOT was reconstructed using autologous pulmonary artery tissue preserved in situ as the posterior wall and a bovine jugular vein patch (BJVP) as the anterior wall in patients with PA-VSD (observation group). The size of the BJVP made from a bovine jugular vein conduit (BJVC) was individually calculated using a formula based on the child’s weight and the size of the autologous pulmonary artery (the diameter of BJVC DBJVC = Dtheoretical-Wz^-4π). Its effect was then compared with the conventional modified Rastelli procedure based on the BJVC (control group). Results: A total of 22 patients that underwent the new procedure were simultaneously compared with the 25 patients in the control group. No deaths occurred in both groups. Notably, there were no significant differences in mechanical ventilation, ICU and postoperative residence, cardiopulmonary bypass, and aortic cross-clamp time. In the follow-up, which spanned for 8–12 years (mean 9.2 years), only four cases with moderate regurgitation were noted in the observation group without obstruction. In the control group, two patients had a conduit replacement. Three patients suffered from anastomotic stenosis, which was corrected by balloon dilatation. Conclusion: Individualized RVOT reconstruction with autologous pulmonary tissue preserved in situ as the posterior wall is adequate for treating PA-VSD.

Congenital heart disease
Pulmonary atresia
Right ventricular outflow tract reconstruction
Bovine jugular vein
Fig. 1.
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