New Valved Conduits for RVOT Reconstruction as a Possible Alternative to Homografts and Contegra Conduits. Manufacturing Technique and First In Vitro Examination

Vachtang Kostava, Marina Zelivyanskaya, Zhanneta Kondratenko, Irina Lyutova

Federal State Budget Institution «A.N. Bakulev National Medical Research Center for Cardiovascular Surgery» of the Ministry of Health of the Russian Federation, Moscow, Russia

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – D

Abstract

Objective. Demand in valved conduits of small (below 12 mm) and large (above 22 mm) diameters remains important problem for RVOT reconstruction in wide range of patients. Here we describe new approach to make such conduits on the basis of cattle large veins and present first in vitro testing data for new grafts.

Methods. Cattle large vein (jugular or femoral) free from native valve cusps serves as the conduit body (tube). In the conduit body is placed stentless tricuspid valve without seams into lumen. Valve has appropriate commissures and adjacent sinuses. Valve leaflets are made from entire sheet of xenopericardium, or cattle Glisson’s capsule, or small interstitial submucosa. All used biomaterials are treated with glutaraldehyde before conduit manufacturing. Pulse duplicator at frequency 100 beat/min and systolic pressures 30 and 60 mm Hg was used to compare new conduit (diameter 14 mm) with same size glutaraldehyde treated cattle jugular vein with native tricuspid valve.

Results. Pulse duplicator examination does not evaluated significant difference in regurgitation fraction and effective orifice area between new hand-made conduit with valve made from cattle Glisson’s capsule from one side and bovine jugular vein with native valve from other side. Video recordings confirmed that in a new conduit valve leaflets exhibit appropriate opening-closure movements during each cycle.

Conclusion. We have developed reproducible and relative simple technology for manufacturing of valved conduits in diameter range 5-26 mm for RVOT reconstruction. Additional in vitro examination, including accelerated fatigue tests, is needed before clinical trials with new implants.