Midterm Outcomes for Polytetrafluoroethylene Valved Conduits

Abstract

Background: Various conduits for right ventricular outflow tract reconstruction have been reported, but most of them are not available in China. The study investigators developed a simple handsewn valved conduit using expanded polytetrafluoroethylene (ePTFE). This study evaluated the midterm outcomes for this conduit.

Methods: This retrospective study included a total of 72 patients who underwent right ventricular outflow tract reconstruction with ePTFE valved conduits between January 2014 and June 2020. During follow-up, echocardiograms were performed for all patients, and magnetic resonance imaging was performed for patients with repaired tetralogy of Fallot.

Results: Patients had a median age of 69 months (interquartile range, 28-127 months) and a median follow-up period of 33 months (interquartile range, 9-51 months). There was no early death, but 2 late deaths (2.78%) occurred. The median conduit size was 18 mm (interquartile range, 18-20 mm) and the z score was +1.3 (interquartile range, +0.6-+2). Peak velocity across the ePTFE valve was 2.38 m/s (95% CI, 2.11-2.63 m/s). Pulmonary valve regurgitation was none or trivial in 27 (38.5%) patients, mild in 42 (60.0%) patients, and moderate in 1 (1.4%) patient. Conduit dysfunction occurred in 5 patients: 4 had moderate conduit stenosis, and 1 had moderate regurgitation. The right ventricular end-diastolic volume index in repaired tetralogy of Fallot was significantly decreased after surgery (171 mL/m² vs 130 mL/m²; P < .001). No reintervention or conduit replacement was needed.

Conclusions: This handsewn ePTFE valved conduit was associated with appreciable hemodynamic outcomes during the midterm follow-up period. Long-term follow-up studies are needed to corroborate these findings.