0.1 mm ePTFE versus autologous pericardium for hand-sewn trileaflet valved conduit: a comparative study

Abstract

A hand-sewn trileaflet valved conduit is reportedly better than a bovine jugular graft. However, the comparative efficacy and safety between 0.1 mm ePTFE and autologous pericardium in this surgical procedure remained undetermined. This single-center cohort study included 46 patients aged 3–146 months who received implanted simplified hand-sewn trileaflet valved conduits: 31 patients (Group A) received 0.1 mm ePTFE valved conduits and 15 patients (Group B) received autologous pericardium valved conduits. Perioperative and follow-up outcomes up to 3 years after the surgeries were evaluated. No perioperative complications or early mortality were observed in either group, while one Group A patient aged 46 months died 6 months after surgery due to residual ventricular septal defect. No patients in Group A developed severe regurgitation or stenosis in valves of the conduits, but two moderate stenosis by echocardiography, and seven patients in group B were deemed to be conduit dysfunction (two stenosis, three stenosis plus regurgitation, and the remaining two regurgitation). No conduits failure was detected in group A, while two patients in group B (one for severe stenosis and the other one for severe regurgitation). After 6, 12, and 36 months, 95.2%, 88.9%, and 88.9% of Group A patients and 92.3%, 68.4%, and 42.7% of Group B patients were free from valved conduit dysfunction. After the same follow-up periods, all Group A patients had no conduit failure and 92.3%, 80.8%, and 80.8% of Group B patients were free from valved conduit failure. Within the 3-year follow-up period, 0.1 mm ePTFE novel simplified hand-sewn trileaflet valved conduits appear to be associated with a lower incidence of graft failure than autologous pericardium valved conduits.

A midterm follow-up study of the application of a confluent aortic valve neocuspidization technique with pericardium in children

“…In our practice, we trimmed the leaflets in equal-size. Our design was based on our successful previous studies about valved conduit for ROVT reconstruction and optimization of the design of leaflets by CFD ( 13 , 14 , 30 ). Theoretically, different-size leaflets are more possible to present eccentric flow, which increases the stress and strain of leaflets, making leaflets more susceptible to deterioration.…”

“…Assuming the measured diameter of annulus of the aortic valve is D, here we designed our leaflet using these equations derived from series of computational fluid dynamics (CFD) experiments and clinical studies of valved conduit ( 13 - 15 ) ( Figure 1 ).…”

Biventricular repair of double-outlet left ventricle by handmade trileaflet-valved conduit: A case report

“…Simultaneously, an assistant accomplished the extracardiac conduit, as shown in the process. [ 4 ] The circumference of the 18 mm Gore-Tex tube was marked at 3 equal points after the inner surface was turned inside out. A 0.1 mm polytetrafluoroethylene sheet was cut into 3 equally connected U-shaped units based on the mold.…”

Application of Homograft Valved Conduit in Cardiac Surgery

“…The results of mid-term clinical trials showed less need for further intervention and severe valvular dysfunction ( 98 , 99 ), especially in valvular regurgitation ( 100 ). And the failure incidence of this conduit is lower than that of autologous pericardial valved conduit operation ( 101 ). A clinical study involving 502 patients also showed satisfactory long-term results, freedom from conduit explantation was 89.0% at 10 years ( 102 ).…”