Clinical experience of ePTFE valved conduit in right ventricular outflow tract reconstruction
Objective; There has been no reasonably durable conduit for right ventricular outflow tract reconstruction (RVOTR) in small pediatric patients so far. We developed ePTFE valved conduit having thin bicuspid ePTFE membrane valve. The early results of this valved conduit were evaluated. Methods;From April 2005 to August 2008, 11 patients underwent RVOTR using valved ePTFE conduit. Mean age at operation was 21.9±17.8months(7days-68.8months) and mean body weight was 9.6±2.9kg(2.98-13kg). The diagnosis was TOF/PA in 9 patients, TGA/VSD/PA in 1 and TOF/APV in 1. The conduit size was 12mm in 1 patient, 14mm in 1, 16mm in 3, 18mm in 6. Mean follow-up duration was 16.5months(4-43.7months). The conduit function was evaluated with transthoracic echocardiography. Results; There was no operative mortality and late death. There were no conduit-related reoperations or postoperative complications including postoperative bleeding, thromboembolism, and thrombotic occlusion. Mean peak systolic pressure gradient between RV and distal MPA at discharge was 14.2±10.0mmHg(0-29.2mmHg). Conduit valve regurgitation was none in 7 patients, trivial in 3, mild in 1. Valve motion was good in 9 patients, not confirmed in 2 because of poor echo window. There were no significant aggravations of valve regurgitation in all patients during follow-up. Among the patients (n=3) who followed up more than 20 months, small increases of pressure gradient between RV and distal MPA were observed (from 17.9mmHg [mean] to 27.1mmHg). Conclusions;ePTFE valved conduit has excellent function in terms of valve regurgitation and conduit pressure gradient without any conduit related complications. Further longer follow-up for this valved conduit function is mandatory.