Reconstruction of right ventricular outflow tract in patients with congenital heart disease in various age groups remains a controversial issue. Currently, a little is known about the fate of secondary and subsequent conduit. The aim of the study was to determine risk factors of conduit failure, evaluate long-term conduit survival, find out which type of conduit should be preferred in case of reoperations. We performed a retrospective analysis of a total of 249 records of valved conduit secondary and subsequent replacement in right ventricular outflow tract in 197 patients. Median follow-up was 5.7 years. The study endpoints were defined as conduit explants; balloon dilatation of the graft (excluding balloon dilatation of left/right pulmonary artery), transcatheter pulmonary valve implantation; heart transplantation or death of the patient. There were total of 21 deaths (11% mortality) among 197 patients during the follow-up, 2 patients underwent heart transplant, in 23 implanted conduits pulmonary angioplasty or/including transcatheter pulmonary valve implantation was afterwards performed due to graft failure, conduit had to be explanted in 46 cases. After 28 years follow-up, freedom from graft failure after 5 years was 77%, 48% after 10 years and 21% after 15 years. Reoperative right ventricular outflow tract reconstruction demonstrates good mid-term and acceptable long-term outcomes regardless of the type of conduit implanted. Worse long-term graft survival of secondary and further conduits is associated with younger age of the recipient at implantation, small size of the conduit, younger age of donor and male donor in case of allograft implantation.

不同年龄段先天性心脏病患者右心室流出道的重建仍存在争议。目前，人们对二级管道和后续管道的命运知之甚少。该研究的目的是确定导管故障的风险因素，评估导管的长期存活率，找出在再次手术的情况下应首选哪种类型的导管。我们对 197 名患者的右心室流出道中的 249 条带瓣导管次级和后续置换的记录进行了回顾性分析。中位随访时间为 5.7 年。研究终点被定义为管道外植体；人工血管球囊扩张术（不包括左/右肺动脉球囊扩张术），经导管肺动脉瓣植入术；心脏移植或患者死亡。197例患者随访期间共死亡21例（死亡率11%），2例患者接受心脏移植，23例置入导管后因移植失败行肺血管成形术或/包括经导管肺动脉瓣植入术，导管不得不移植 46 例。经过 28 年的随访，5 年后无移植失败率为 77%，10 年后为 48%，15 年后为 21%。无论植入的导管类型如何，再次手术右心室流出道重建都显示出良好的中期和可接受的长期结果。在同种异体移植物植入的情况下，二级和更远导管的较差的长期移植物存活与植入时受体年龄较小、导管尺寸较小、供体和男性供体年龄较小有关。