[III-JCKAP6-1-1] Surgical outcomes of ePTFE valved conduit for RVOTR in the patients of congenital heart disease
Keywords:ePTFE, RVOT, CHD
[Background] We developed a handmade expanded polytetrafluoroethylene (ePTFE) pulmonary valvular conduit (PVC) with bulging sinuses and a fan-shaped ePTFE valve for the right ventricular outflow tract (RVOT) reconstruction and have reported excellent long-term outcome. We will introduce surgical outcomes of ePTFE PVC who underwent biventricular definitive repair. [Methods] From 2001 to 2020, 1776 patients underwent RVOT reconstruction using ePTFE PVCs in Japan. The follow-up of this study was completed in 2021. The median age and body weight were 4.1 years (range, 3 days to 67.1 years) and 13.3 (range, 1.8 to 91.3) kg, respectively. The median PVC size was 18 (range, 8 to 24) mm. The median follow-up period was 3.3 years (range, 0 day to 16.2 years). [Results] There were only 9 cases (0.5%) with PVC-related unknown deaths. The overall survival rate at 10 years was 95.2%. Reintervention was performed in 283 patients (15.9%), and 190 patients (10.7%) required PVC explantation. Freedom from reintervention and explantation at 10 years were 61.5% and 69.1%, respectively. At the latest echocardiography, PVC regurgitation grade was better than mild in 88.4% patients. The average peak RVOT gradient was 15.7 ± 15.9 mm Hg at the latest cardiac catheterization. ePTFE PVC infection was detected in only 8 patients (0.5%). Freedom form PVC related infective endocarditis at 10 years was 98.4%. [Conclusions] The durability, valvular performance, and the resistance against infection of PVC were satisfactory. Our handmade PVC may replace conventional prosthetic materials.