title: Expanded polytetrafluoroethylene conduits and patches with bulging sinuses and fan-shaped valves in right ventricular outflow tract reconstruction: multicenter study in Japan.
abstract: 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.
  
  
  METHODS
  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.
authors: Department of Pediatric Cardiovascular Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Takako
authors: T
authors: Miyazaki
authors: Masaaki
authors: M
authors: Yamagishi
authors: Yoashinobu
authors: Y
authors: Maeda
authors: Yusuke
authors: Y
authors: Yamamoto
authors: Satoshi
authors: S
authors: Taniguchi
authors: Yuji
authors: Y
authors: Sasaki
authors: Hitoshi
authors: H
authors: Yaku
mesh_terms: D000293:Adolescent; D000328:Adult; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D054326:Coronary Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D015150:Echocardiography, Doppler; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D055815:Young Adult
chemical_list: D011138:Polytetrafluoroethylene