ABSTRACT
The modified Brock technique involves placing a purse-string suture and Rumel tourniquet in the right ventricle and a right ventriculotomy incision is made. An infundibular rongeur is inserted and the Rumel tightened. The subvalvular stenosis and infundibular muscle is removed. When complete, the purse-string is tied off to close the ventriculotomy. The patch graft technique involves placing a patch over the pulmonary outflow tract between the right ventricle and the pulmonary artery. A preplaced wire or cutting suture is used to cut the outflow tract, allowing blood to fill the patch and the widened outflow tract. This technique enlarges the outflow tract and allows blood to flow more easily to the pulmonary artery. The conduit technique accomplishes the same goal as the patch graft by bypassing the pulmonary outflow tract; a synthetic vascular conduit is placed between the right ventricle and the pulmonary artery. Conduits are available with or without a valve to prevent regurgitation.
