Right Ventricle to Pulmonary Artery Conduits in Adult Patients with Conotruncal Lesions: Single-Center Experience

All articles of this category (opens in new window) Background: The number of adult patients with congenital conotruncal anomalies requiring the replacement of a previously implanted right ventricle to pulmonary artery conduit is rising. Novel types of substitutes with less structural deterioration and a low number of re-interventions are needed. This retrospective analysis compares Xenografts, cryopreserved homografts, and decellularized homografts in adult patients with conotruncal anomalies. Methods: All Patients above the age of 18 years with conotruncal anomalies who had undergone a right ventricle to pulmonary artery conduit placement or implantation using a Xenograft (Edwards-Inspiris, Abbott-Trifecta, Medtronic-Mosaic), cryopreserved homograft, or decellularized homograft between 2015 and 2025 were included in this single-center retrospective analysis. Demographic data, medical history, and operative data of each patient were obtained. The latest transthoracic echocardiography findings in routine follow-up and clinical reports were collected. Statistics: Kruskal–Wallis test for the comparison of medians and chi-square test for comparison of categorical data were used. Kaplan–Meier estimated survival curves with 95% confidence interval were calculated, log-rank test was performed to compare survival between groups. Kaplan–Meier curves were used to analyze freedom from reoperation in each group and of the total cohort. Results: A total of 53 patients were included: 13 received decellularized homografts, 14 cryopreserved homografts, and 26 xenografts. Median age at surgery was 29 years (IQR: 21–38). The most frequent primary diagnosis was tetralogy of Fallot (39.6%), followed by congenital pulmonary stenosis (13.2%) and dTGA with LVOTO (11.3%). Median follow-up was 59 months. Hemodynamic results were similar, with a median mean gradient of 7 mm Hg and peak gradient of 12 mm Hg, with no intergroup differences ( p = 0.923 and p = 0.907, respectively). Prosthesis regurgitation was trivial in 11 patients and mild in 4, with no severe regurgitation reported ( p = 0.347). Two patients in the bioprosthetic group and one patient in the cryopreserved homograft group required reoperation at 19, 81, and 97 months after the date of implantation. Conclusion: At a median follow-up period of 5 years, decellularized homografts in adult patients with conotruncal anomalies demonstrate no surgical reinterventions compared with cryopreserved homografts and xenografts. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany