title: Valved Polytetrafluoroethylene Conduits for Right Ventricular Outflow Tract Reconstruction.
abstract: BACKGROUND
  The purposes of this study were to review our early outcomes using valved expanded polytetrafluoroethylene (ePTFE) conduits, with or without bulging sinus structure, for right ventricular outflow tract reconstruction and to examine the mechanical properties of the ePTFE material after bulging sinuses were created.
  
  
  METHODS
  A retrospective review was performed of all patients who received the valved ePTFE conduit between 2008 and 2014 at a single institution. The surface morphologies and the mechanical strengths of the ePTFE conduit with bulging sinuses examined by scanning electron microscopy and unidirectional pull test were compared with those of the original ePTFE material.
  
  
  RESULTS
  There were 120 operations with the valved ePTFE conduit (60 with bulging sinuses). The patients median age and weight were 6.9 years and 23.7 kg. The conduits were a median size of 22 mm. At 5 years, freedom from conduit reoperation was 92.7% (95% confidence interval, 82.7% to 97.0%), and freedom from severe conduit insufficiency or more than a 50 mm Hg gradient was 74.8% (95% confidence interval, 60.8% to 84.4%). No significant differences in the surface morphologies were observed by the scanning electron microscopy or in the maximum tolerated loads obtained by the pull test between the original ePTFE material and the ePTFE with bulging sinuses (121 and 122 N in longitudinal direction and 115 and 121 N in circumferential direction; p = 0.88 and p = 0.68).
  
  
  CONCLUSIONS
  The valved ePTFE conduits demonstrated excellent early clinical outcomes. The mechanical property examinations showed no obvious difference after bulging sinuses were created on the ePTFE material.
authors.affiliation: Division of Pediatric and Congenital Cardiothoracic Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address: tshinkawa@uams.edu.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shinkawa
authors.affiliation: Biostatistics Program, Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Tang
authors.affiliation: Biostatistics Program, Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Gossett
authors.affiliation: Center for Integrative Nanotechnology Sciences, University of Arkansas at Little Rock, Little Rock, Arkansas.
authors.forename: Thikra
authors.initials: T
authors.lastname: Mustafa
authors.affiliation: Center for Integrative Nanotechnology Sciences, University of Arkansas at Little Rock, Little Rock, Arkansas.
authors.forename: Festus
authors.initials: F
authors.lastname: Hategekimana
authors.affiliation: Center for Integrative Nanotechnology Sciences, University of Arkansas at Little Rock, Little Rock, Arkansas.
authors.forename: Fumiya
authors.initials: F
authors.lastname: Watanabe
authors.affiliation: Children's Medical Center, Department of Pediatric Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Children's Medical Center, Department of Pediatric Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yamagishi
authors.affiliation: Division of Pediatric and Congenital Cardiothoracic Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Imamura
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012189:Retrospective Studies; D014694:Ventricular Outflow Obstruction / Q000601:surgery*; D055815:Young Adult
chemical_list: D011138:Polytetrafluoroethylene