Avoiding compression of extracardiac valved conduits.

Extracardiac valved conduits are routinely employed in the correction of complex congenital heart lesions. Compression of a conduit and/or of the heart may present serious operative and postoperative complications. We believe its occurrence can be minimized and hemodynamic results improved by adhering to simple surgical techniques. It is important to select a conduit which will produce minimal resistance to flow. Partial or subtotal thymectomy may increase the mediastinal space to accommodate the conduit. The conduit should be cut into the appropriate shape and should be placed in such a way that it does not cross the midline. Finally, the posterior pericardium may be opened to allow the heart to move posteriorly and to rotate to the left, thus moving the conduit away from the sternum.