HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ando, M. Articles by Takahashi, Y. Search for Related Content PubMed Articles by Ando, M. Articles by Takahashi, Y. Related Collections Congenital - acyanotic Congenital - cyanotic

J Thorac Cardiovasc Surg 2009;137:124-131
© 2009 The American Association for Thoracic Surgery

Congenital Heart Disease

Ten-year experience with handmade trileaflet polytetrafluoroethylene valved conduit used for pulmonary reconstruction

Department of Pediatric Cardiac Surgery, Sakakibara Heart Institute, Tokyo, Japan

Received for publication June 16, 2008; revisions received August 11, 2008; accepted for publication August 31, 2008.

^_* Address for reprints: Makoto Ando, MD, Department of Pediatric Cardiac Surgery, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-si, Tokyo 183-0003, Japan. (Email: maando{at}shi.heart.or.jp).

Objective: The objective of this study was to investigate the results of handmade polytetrafluoroethylene trileaflet conduits implanted in the pulmonary position since 1997.

Methods: One hundred thirty-nine patients underwent pulmonary reconstruction with a polytetrafluoroethylene conduit. Conduit function was investigated by means of review of serial echocardiographic studies.

Results: Mean age and body weight were 12.7 ± 12.0 years and 30.9 ± 20.6 kg. Mean size of the conduit was 21.0 ± 3.8 mm (12–28 mm). The z score of the conduit was +0.5 ± 0.8 for patients older than 15 years (n = 43), +1.2 ± 0.7 for patients 5 to 15 years old (n = 48), and +2.4 ± 0.5 for patients younger than 5 years (n = 48). Conduits were used for the Ross procedure in 21 patients and for repair of complex congenital heart disease in 118 patients. There were 3 (2.2%) in-hospital deaths and 1 late death. Four patients required conduit explantation because of pulmonary artery distortion at a distal anastomotic site (interval, 1.2 years), infection of the polytetrafluoroethylene valve (interval, 1.6 years), midportion angulation of the conduit (interval, 4.9 years), and conduit compression by the ascending aorta (interval, 5.4 years). Estimated freedom from conduit explantation was 88.0% ± 6.8%, and pulmonary insufficiency was less than or equal to mild in 75.0% at 10 years. All valves maintained their motion, and the mean estimated pressure gradient across the conduit was 19.6 ± 11.9 mm Hg at 5 years and appeared to reach a plateau thereafter. The pressure gradient across the conduit was 14.2 ± 8.0 mm Hg at 3 years (P = .0127) and 18.1 ± 7.5 mm Hg at 7 years (P = .0208).

Conclusions: Polytetrafluoroethylene conduits represent a valid option and reliable alternative to homograft and xenograft implantation for pulmonary reconstruction.

This article has been cited by other articles:

				M. Nosal', R. Poruban, P. Valentik, M. Sagat, A. S. Nagi, and A. Kantorova Initial experience with polytetrafluoroethylene leaflet extensions for aortic valve repair Eur J Cardiothorac Surg, January 12, 2012; (2012) ezr214v1. [Abstract] [Full Text] [PDF]

				T. Miyazaki, M. Yamagishi, Y. Maeda, Y. Yamamoto, S. Taniguchi, Y. Sasaki, and H. Yaku Expanded polytetrafluoroethylene conduits and patches with bulging sinuses and fan-shaped valves in right ventricular outflow tract reconstruction: Multicenter study in Japan J. Thorac. Cardiovasc. Surg., November 1, 2011; 142(5): 1122 - 1129. [Abstract] [Full Text] [PDF]

				M. J. Russo, R. Easterwood, M. R. Williams, I. George, and A. S. Stewart Aortic Root and Right Ventricular Outflow Tract Reconstruction Using Composite Biological Valved Conduits After Failed Ross Procedure Ann. Thorac. Surg., June 1, 2011; 91(6): e87 - e89. [Abstract] [Full Text] [PDF]

				M. Yoshida, P. D. Wearden, O. Dur, K. Pekkan, and V. O. Morell Right Ventricular Outflow Tract Reconstruction With Bicuspid Valved Polytetrafluoroethylene Conduit Ann. Thorac. Surg., April 1, 2011; 91(4): 1235 - 1239. [Abstract] [Full Text] [PDF]

				I. George, J. N. Shah, M. Bacchetta, and A. Stewart Stentless Bioprosthesis in a Valved Conduit: Implications for Pulmonary Reconstruction Ann. Thorac. Surg., December 1, 2009; 88(6): 2022 - 2024. [Abstract] [Full Text] [PDF]