Clinical outcomes of handmade polytetrafluoroethylene trileaflet valved conduit used for pulmonary valve replacement

Te-I Chang, Kang-Hong Hsu, Wei-Li Hung, Shu-Jen Yeh, Ming-Ren Chen, Yu-San Chien, Ron-Bin Hsu, Jou-Kou Wang, Ruey-Feng Chang, Chung-I Chang

研究成果: 雜誌貢獻文章同行評審

1 引文 斯高帕斯(Scopus)


OBJECTIVES: To mitigate the shortage of homograft sources, the use of handmade trileaflet expanded polytetrafluoroethylene valves in pulmonary valve replacement has shown excellent results from multicentre studies conducted in Japan. However, world-wide data outside Japan is relative insufficient. This study presents the long-term results of a single surgeon's use of flipped-back trileaflet method in a 10-year case series.

METHODS: We have developed an efficient way to make a trileaflet-valved conduit utilizing flipped-back method for pulmonary valve replacement and have employed the technique since 2011. Retrospective data were studied between October 2010 and January 2020. Echocardiography, electrocardiogram, Pro-Brain Natriuretic Peptide, and Magnetic Resonance Imaging data were analyzed.

RESULTS: 55 patients were reviewed and median follow-up duration was 2.9 years. The majority of diagnoses was Tetralogy of Fallot (n = 41), and these patients subsequently underwent secondary pulmonary valve replacement at a median age of 15.6 years. Survival was 92.7% with the longest follow-up period being 10 years. There was no need for reoperation, and freedom from reintervention was 98.0% at 10 years. There were 4 deaths (3 in-hospital and 1 outpatient). One patient eventually received transcatheter pulmonary valve implantation. Postoperative echocardiography showed mild or less pulmonary stenosis and pulmonary regurgitation degree in 92.2% and 92.0% of patients, respectively. Comparable magnetic resonance imaging data (n = 25) showed significant reduction in right ventricular volumes but not in ejection fractions.

CONCLUSION: Our series showed satisfactory long-term function of handmade flipped-back trileaflet valved conduit used in our patients. The simple design is efficiently reproducible without complex fabrication process.
期刊European Journal of Cardio-thoracic Surgery
出版狀態打印前電子出版 - 3月 2023


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