Apicoaortic conduits for complex left ventricular outflow obstruction: 10-year experience.

We interposed valved conduits between the left ventricular apex and aorta in 38 patients over a 10-year period. Indications included tunnel subaortic stenosis, aortic annular hypoplasia, tubular supravalvular aortic hypoplasia, and severe calcification of the ascending aorta. Operative mortality was 11%, but 78% of the survivors were alive at 5 years, and 70% had had no major complication. The results were better in adolescents and adults than in young children. Although complications included calcific degeneration of the valve and disruption of the conduit at the site of insertion into the ventricular apex, we continue to believe in the utility of this procedure in a few patients with complex left ventricular outflow tract obstruction.