[Reconstruction of the right ventricular outflow tract in tetralogy of Fallot with a Hancock valve containing ventriculo-pulmonary conduit (author's transl)].

Between June 1975 and August 1978, 22 cases of anatomically and functionally severe tetralogy of Fallot were corrected with a valve bearing ventriculo-pulmonary Hancock conduit. The indication for use of the Hancock conduit was atresia of the pulmonary valve ring and main pulmonary artery (classified according to Sommerville and Jefferson as types I and II respectively) in 5 patients, severe hypoplasia of the pulmonary valve ring, the right ventricular outflow tract (RVOT) and the main pulmonary artery in 10, 1 patient with an abnormal right coronary artery and an acquired obstruction of the infundibulum subsequent to Waterston-Cooley anastomosis in 4 patients. Hancock conduits (KHP) were also employed in two patients with severe pulmonary insufficiency after patch insertion across the pulmonary valve ring. Early mortality was 9%. Very good hemodynamic results were achieved in 15 patients (with pRV/pLV ratios less than 0.4 in 8 and between 0.4 and 0.5 in 5 patients). Good results (as indicated by pRV/pLV ratios between 0.5 and 0.7) were found in 7 patients, while only in 2 patients a ratio greater than 0.7 indicated an insufficient hemodynamic result. The valve bearing ventriculo-pulmonary Hancock conduit is the surgical method of choice for various types of atresia of the RVOT. As opposed to transanular reconstruction of the RVOT which, dependent on the extent of hypoplasia, consistently leads to some degree of pulmonary insufficiency, the use of the Hancock conduit can prevent pulmonary regurgitation.