Replacement of Obstructed Right Ventricle to Pulmonary Artery Conduits: The Modified Peel Operation.

Reconstruction of the right outflow tract with extracardiac conduits has made complete repair of complex cardiac malformations possible. However, reoperation is usually required for a right ventricle-to-pulmonary artery conduit obstruction. We describe a modified peel operation, where the sides and posterior half of the previously placed conduit are preserved, and a prosthetic roof is placed over the conduit remnant.