Expanded polytetrafluoroethylene conduits and patches with bulging sinuses and fan-shaped valves in right ventricular outflow tract reconstruction: Multicenter study in Japan
Expanded polytetrafluoroethylene conduits and patches with bulging sinuses and fan-shaped valves in right ventricular outflow tract reconstruction: Multicenter study in Japan
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DOI：
10.1016/j.jtcvs.2011.08.018
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发表时间：
2011-11-01
影响因子：
6
通讯作者：
Yaku, Hitoshi
中科院分区：
文献类型：
--
作者：
Miyazaki, Takako;Yamagishi, Masaaki;Yaku, Hitoshi
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Objective: There is no optimal substitute for right ventricular outflow tract (RVOT) reconstruction in congenital heart defects. Expanded polytetrafluoroethylene (ePTFE) valved conduits and patches may be a good alternative to homografts and bovine jugular veins. We have developed a fan-shaped ePTFE valve and an ePTFE valved conduit and patch with bulging sinuses with the aim of enhancing the long-term valve function.Method: Bulging sinuses were constructed on ePTFE conduits and patches as described previously (J Thorac Cardiovasc Surg. 2007;134:327-32). Between February 2001 and January 2011, 794 patients (aged 14 days to 56.8 years old; median, 2.0 years old) had ePTFE valves implanted for RVOT reconstruction at 52 Japanese institutes. Conduits with a fan-shaped ePTFE valve were implanted in 325 patients and a patch with a fan-shaped ePTFE valve was implanted in 469 patients. Valve function was assessed by a series of echocardiograms postoperatively.Results: The mean follow-up was 3.6 years (1.1 months to 10.0 years). Freedom from reoperation at 10 years was 95.4% in patients with conduits and 92.3% in those with patches. Pulmonary insufficiency was mild or nonexistent in 95.0% of patients with conduits and 79.6% of patients with patches. The pressure gradient between the right ventricle and the pulmonary artery was 14.0 +/- 13.2 mm Hg in patients with conduits and 11.6 +/- 11.6 mm Hg in patients with patches.Conclusions: Fan-shaped ePTFE valved conduits and patches with bulging sinuses have a high freedom from reoperation and prevent pulmonary insufficiency. They represent a promising material for RVOT reconstruction. (J Thorac Cardiovasc Surg 2011;142:1122-9)