What is a valved conduit ?

A conduit is a tube used to connect the ventricle and pulmonary artery. It may be made of fabric like Dacron or PTFE, or may be a homograft (aortic or pulmonary), or sometimes even pericardium fashioned into a hollow tube. A homograft conduit will have a valve inside it. A fabric or pericardium conduit can be modified to have either a prosthetic valve or a "monocusp" valve inside it.

The conduit is connected by sutures on one side to the pulmonary artery (or its branches) and on the other end to the opening in the right ventricle. Blood can now flow across the conduit from the right ventricle into the lungs.

What are the risks of operation ?

Repair of truncus arteriosus is a risky operation since it is done on very small children with a complex heart problem. But with growing experience, results have improved tremendously, and specialized centers have an acceptably small risk of mortality and morbidity.

Problems might arise due to

• leaky truncal valves, which might need to be repaired or rarely even replaced by mechanical prosthetic valves.
• abnormal coronary arteries.
• associated conditions like interrupted aortic arch, which can be corrected at the same procedure but increase the risk slightly.

After surgery, a complication that often occurs is a condition called Pulmonary Hypertensive Crisis. In this condition, there are sudden episodes of severely increased lung blood pressure. These must be anticipated and treated vigorously and might rarely be fatal.

What is the long term outcome after surgery for truncus arteriosus ?

If there's anything more you want to read about, or some areas which aren't clear enough, don't hesitate to write and let me know.

 

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