Table 1.

Current Surgical Valved Conduits to Replace the Right Ventricular Outflow Tract.

Current Surgical Devices	Reoperation Rates	Limitations	Ref.
Cryopreserved homografts	6%–58% at 5 years, 36%–90% at 15 years, depending on the diameter, age at surgery, and heart defect	No growth potential Immunogenicity and inflammatory response Calcification Structural degeneration Limited availability	18, 22
Stented heterografts (e.g. Hancock® tube: porcine aortic heart valve in a tube made of Dacron®)	19% at 5 years, 68% at 10 years, 95%–100% at 15 years, depending on the diameter, age at surgery, and heart defect	No growth potential Early calcification Structural degeneration Pannus formation Excessive stiffness with anatomic compression/distortion	23
Stentless heterografts (e.g. Contegra® tube: bovine jugular vein)	22%–40% at 5 years, depending on the diameter, age at surgery, and heart defect	No growth potential Immunogenicity and inflammatory response Stenosis of the distal anastomosis Pseudoaneurysm of the proximal anastomosis Severe conduit regurgitation	24, 25
Stentless heterografts (e.g. Shelhigh® tube: porcine pulmonary heart valve in a tube made of bovine pericardium)	48%–67% at 1 year, depending on the diameter, age at surgery, and heart defect	Intimal peel formation at the distal segment No growth potential Immunogenicity and inflammatory response Pseudoaneurysm	26
Mechanical valves	Only in older children and adults	No growth potential Anticoagulant therapy required Thromboembolic complications	27