Long-term outcomes of expanded polytetrafluoroethylene conduits with bulging sinuses and a fan-shaped valve in right ventricular outflow tract reconstruction

Abstract Objective Various types of conduits are available for right ventricular outflow tract (RVOT) reconstruction. We have developed an expanded polytetrafluoroethylene (ePTFE) conduit with bulging sinuses and a fan-shaped ePTFE valve. This study summarized the results of a multicenter study evaluating the valved ePTFE conduit. Methods The valve functions of 902 patients (median age, 3.9 years; median weight, 12.6 kg) who underwent RVOT reconstruction using valved ePTFE conduits (9 different sizes, 8-24 mm in diameter) at 65 hospitals between 2001 and 2015 were retrospectively investigated. Median follow-up time was 5.5 years. The valve functions were assessed using echocardiography, cardiac catheterization, and magnetic resonance angiography. Results There were no deaths related to the ePTFE conduit. The peak RVOT gradient was 16.5 ± 13.1 mm Hg, and pulmonary insufficiency graded better than mild was 95.9% at the latest follow-up. Conduit replacement was performed in 55 patients, and in only 3 patients because of conduit infection. Freedom from intervention at 5 years and 10 years was 92.3% and 76.1%, respectively, with small conduits (8-16 mm in diameter) and 99.6% and 95.1%, respectively, with large conduits (18-24 mm in diameter). Conclusions The long-term outcomes of the ePTFE conduit with a fan-shaped valve and bulging sinuses appear clinically satisfactory. We believe that the longevity of small-sized conduits can yield sufficient time to exchange them to larger-sized conduits without any loss of their valve functions. Regarding longevity and resistance to infections, this ePTFE valved conduit can be one of the best ways to reconstruct the RVOT.