Christopher W. Baird, MD, Patrick O

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Ring-Reinforced Sano Conduit at Norwood Stage I Reduces Proximal Conduit Obstruction Christopher W. Baird, MD, Patrick O. Myers, MD, Michele Borisuk, MSN, CPNP, Frank A. Pigula, MD, Sitaram M. Emani, MD The Annals of Thoracic Surgery Volume 99, Issue 1, Pages 171-179 (January 2015) DOI: 10.1016/j.athoracsur.2014.08.078 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 A series of magnetic resonance images from a patient having undergone a stage I procedure with a right ventricle-to-pulmonary artery conduit just before a bidirectional Glenn procedure. It shows very localized right ventricular hypokinesis/dyskinesis around the “dunked” right ventricle-to-pulmonary artery conduit insertion site, with no evidence of late gadolinium enhancement suggesting preserved ventricular function. The Annals of Thoracic Surgery 2015 99, 171-179DOI: (10.1016/j.athoracsur.2014.08.078) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Kaplan-Meier estimates of freedom from interstage right ventricle-to-pulmonary artery (RV-PA) conduit proximal insertion site (A) reintervention and (B) complications for dunked conduit (blue line) and traditional conduit (green line). Complications were defined as reintervention, reoperation, moderate to severe obstruction without reintervention or reoperation at follow-up, or bidirectional Glenn procedure or pseudoaneurysm development. The Annals of Thoracic Surgery 2015 99, 171-179DOI: (10.1016/j.athoracsur.2014.08.078) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Kaplan-Meier estimates of survival for patients with dunked conduit (blue line) and traditional conduit (green line). The Annals of Thoracic Surgery 2015 99, 171-179DOI: (10.1016/j.athoracsur.2014.08.078) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Postmortem studies examining a ringed Gore-Tex (W.L. Gore and Associates, Elkton, MD) conduit dunked into the right ventricular infundibulum. (A) Magnetic resonance imaging details the course of the modified Sano conduit. (B) Gross pathologic specimen shows the ring-reinforced Gore-Tex Sano conduit inserted into the infundibulum of the right ventricle, without evidence of proximal conduit obstruction. The Annals of Thoracic Surgery 2015 99, 171-179DOI: (10.1016/j.athoracsur.2014.08.078) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions