Expanded polytetrafluoroethylene-valved conduit with bulging sinuses for right ventricular outflow tract reconstruction in adults.
OBJECTIVE
Generally, right ventricular outflow tract reconstruction in adults is performed using homografts or xenograft. However, sufficient graft material is difficult to obtain and has the problems of calcification and structure destruction. We, therefore, evaluated using expanded polytetrafluoroethylene- (ePTFE)-valved conduits with bulging sinuses for right ventricular outflow tract reconstruction in adults.


METHODS
Between February 2006 and April 2008, a total of five patients (three men, two women), ages 25-51 years old (mean +/- SD, 40 +/- 11 years)] underwent right ventricular outflow tract (RVOT) reconstruction in our institution. In three patients, RVOT reconstruction was performed with the Ross procedure; and in all cases, tricuspid ePTFE (valved conduits with bulging sinuses were used. The diameter of the conduit was determined according to the RVOT size. Valve function was followed up using echocardiography after surgery and during the early/mid-term periods of recovery (13 months to 3.0 years).


RESULTS
No morbidity occurred, and no patient required further surgery during the follow-up period. During these follow-up periods, pulmonary observation revealed that no patients had stenosis; regurgitation was mild in one patient and trivial in four patients. In regard to the tricuspid valve, regurgitation was trivial in four patients and mild in one patient.


CONCLUSIONS
Although long-term follow-up is required to confirm the durability of the ePTFE-valved conduit with bulging sinuses, the present results indicate a satisfactory result in patients who undergo RVOT reconstruction, even in adult cases.
Takahashi
Yosuke
Y
Department of Cardiovascular Surgery, Fukui Cardiovascular Center, 2-228 Shinbo, Fukui, Fukui 910-0833, Japan. ysk@msic.med.osaka-cu.ac.jp
Tsutsumi
Yasushi
Y
Monta
Osamu
O
Kato
Yasuyuki
Y
Kohshi
Keitaro
K
Sakamoto
Tomohiko
T
Ohashi
Hirokazu
H
Miyazaki
Takako
T
Yamagishi
Masaaki
M
D000328:Adult; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D018618:Echocardiography, Doppler, Color; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D011665:Pulmonary Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*
D011138:Polytetrafluoroethylene