Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

Tao Qian; Haoyong Yuan; Chunyang Chen; Yuhong Liu; Ting Lu; Can Huang; Zhongshi Wu

doi:10.3389/fsurg.2021.719840

Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

Front Surg. 2021 Sep 22:8:719840. doi: 10.3389/fsurg.2021.719840. eCollection 2021.

Authors

Tao Qian^{1

2}, Haoyong Yuan^{1

2}, Chunyang Chen^{1

2}, Yuhong Liu^{1

2}, Ting Lu^{1

2}, Can Huang^{1

2}, Zhongshi Wu^{1

2}

Affiliations

¹ Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
² Engineering Laboratory of Hunan Province for Cardiovascular Biomaterials, Changsha, China.

Abstract

Purpose of Review: Right ventricular outflow tract (RVOT) reconstruction remains a challenge due to the lack of an ideal conduit. Data and experience are accumulating with each passing day. Therefore, it is necessary to review this topic from time to time. This is a 2021 update review focused on the history, evolution, and current situation of small-sized conduits (≤ 16 mm) for RVOT reconstruction in infants and young children. Recent Findings: Currently, the available small-sized (≤16 mm) conduits can meet most clinical needs. Homograft is still a reliable choice for infants and young children validated by a half-century clinical experience. As an alternative material, bovine jugular vein conduit (BJVC) has at least comparable durability with that of homograft. The performance of expanded polytetrafluoroethylene (ePTFE) is amazing in RVOT position according to limited published data. The past century has witnessed much progress in the materials for RVOT reconstruction. However, lack of growth potential is the dilemma for small-sized conduits. Tissue-engineering based on cell-free scaffolds is the most promising technology to obtain the ideal conduit. Summary: No conduit has proved to have lifelong durability in RVOT position. We are far from the ideal, but we are not in a state of emergency. In-depth clinical research as well as innovation in material science are needed to help improve the durability of the conduits used in infants and young children.

Keywords: bovine jugular vein conduit; children; expanded polytetrafluoroethylene; homograft; right ventricular outflow react reconstruction; tissue engineering; valved conduit.

Publication types

Review