Short-term outcomes of the right ventricle to pulmonary artery conduit “NeoCor” in Syria: A case series

Background

Right ventricle–to–pulmonary artery (RV–PA) reconstruction often requires a valved conduit; however, no single option is ideal across ages and anatomical variations. We report early outcomes of a bovine pericardial xenograft conduit (NeoCor) as a practical solution in a resource-limited setting.

Methods

In this single-center retrospective series, eight pediatric patients (1–14 years) underwent RV–PA reconstruction (2019–2024) using a bovine pericardial xenograft conduit sized by nomogram (10–21 mm). A single surgical team performed all procedures under standardized perioperative protocols with intraoperative echocardiography. Complications were graded using standardized criteria. The primary outcome was clean follow-up (no mortality, no reintervention on the conduit/RVOT, no ≥moderate conduit regurgitation, peak Doppler gradient ≤30 mmHg, and no echogenic calcification).

Results

Indications included TGA/VSD/PS (n = 4), tetralogy of Fallot with absent pulmonary valve (n = 2), VSD–PA with confluent PAs/PDA (n = 1), and truncus arteriosus redo (n = 1). Follow-up ranged 6 months–5 years (mean 2 years). All patients met the clean follow-up definition. Conduit Doppler gradients were 5–8 mmHg perioperatively and 8–12 mmHg at follow-up; no calcification or ≥ moderate regurgitation was observed.

Conclusions

A bovine pericardial xenograft conduit is a feasible, accessible option for RV–PA reconstruction with promising short-term hemodynamics in this context. Larger prospective studies and/or registry participation are warranted to evaluate durability, reintervention rates, and cost-effectiveness.