Right ventricular outflow tract reconstruction using a polytetrafluoroethylene conduit in Ross patients

Eur J Cardiothorac Surg. 2018 Sep 1;54(3):427-433. doi: 10.1093/ejcts/ezy128.

Abstract

Objectives: The type of conduit used for right ventricular outflow tract (RVOT) reconstruction during the Ross procedure remains problematic because of the limited availability of pulmonary allografts and the unsatisfactory long-term results associated with the use of xenografts. Polytetrafluoroethylene (PTFE) conduits have been proposed as an alternative. This study evaluated the results of RVOT reconstruction using a PTFE conduit during the Ross procedure.

Methods: Between 2007 and 2015, 28 patients underwent RVOT reconstruction using PTFE conduits. The mean age of the patients was 35.9 ± 18.1 (range 4-58) years. The total root replacement technique was used in all patients. The mean PTFE conduit size was 25.3 ± 2.3 mm.

Results: The early mortality rate was 3.6% (1 patient). The mean follow-up duration was 48.5 ± 31.2 months; there were no late deaths. The transprosthetic gradients increased significantly over time. The conduit size was the only independent predictor of peak RVOT gradient progression (P = 0.02). None of the patients demonstrated significant RVOT regurgitation. One patient required an RVOT reoperation.

Conclusions: The PTFE conduit demonstrates acceptable haemodynamic results at the mid-term follow-up and could be considered as an alternative substitute for RVOT reconstruction during the Ross procedure.

MeSH terms

  • Adolescent
  • Adult
  • Aortic Valve / surgery
  • Blood Vessel Prosthesis
  • Child
  • Child, Preschool
  • Female
  • Heart Valve Diseases / surgery
  • Heart Valve Prosthesis Implantation* / instrumentation
  • Heart Valve Prosthesis Implantation* / methods
  • Heart Valve Prosthesis Implantation* / mortality
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Polytetrafluoroethylene / therapeutic use*
  • Prosthesis Design
  • Retrospective Studies
  • Ventricular Outflow Obstruction / surgery*
  • Young Adult

Substances

  • Polytetrafluoroethylene