Applicability of handmade expanded polytetrafluoroethylene trileaflet-valved conduits for pulmonary valve reconstruction: An ex vivo and in vivo study

Abstract

The ePTFE trileaflet-valved conduits for pulmonary valve reconstruction showed acceptable performance and outcomes in the ex vivo and in vivo experiments. The ePTFE trileaflet-valved conduit may be clinically useful, although additional studies in animals should be conducted to determine its long-term outcomes.

Hemodynamic Performance Validation of Customized Handmade Trileaflet-valved Conduits Using Taguchi Method and Likelihood Degree Estimation

“…Hence, previous studies have used handmade trileaflet-valved conduits (HTVCs) with expanded polytetrafluoroethylene (ePTFE) to reconstruct the right ventricular outflow tract (RVOT) without the need for open-heart surgery. (7)(8)(9) In relation to this reason, the purpose of this study is to validate the performance of customized HTVCs for pulmonary valve reconstruction using the Taguchi method by taking into account signal-to-noise (S/N) ratios under different heart rates (HR), blood flow volumes, and hypertension conditions.…”

“…However, these prosthetic valved conduits also have issues of availability, durability, and size limitations, thereby restricting their usage in both child and adult patients. To overcome the restrictions, previous studies (7)(8)(9)15) have presented HTVCs that provide a large range of customized diameters for RVOT reconstructions. ePTFE has good biocompatibility (and has been approved by the Taiwan Food and Drug Administration) and possesses low tissue affinity against valve degeneration and calcification.…”

Designing valves: An art or science?

“…Analytic approaches that are based on engineering principles have also been proposed, 1,2 promising a more precisionbased individual approach. 3 The article in this issue of the Journal by Kan and colleagues 4 describes a handmade expanded polytetrafluoroethylene valved conduit for right ventricular outflow tract reconstruction and reports acceptable in vitro and in vivo performance. Although others have presented similar expanded polytetrafluoroethylene valved conduits, 5 an important contribution of Kan and colleagues 4 is the quantitative description that allows others to recreate their design.…”

“…3 The article in this issue of the Journal by Kan and colleagues 4 describes a handmade expanded polytetrafluoroethylene valved conduit for right ventricular outflow tract reconstruction and reports acceptable in vitro and in vivo performance. Although others have presented similar expanded polytetrafluoroethylene valved conduits, 5 an important contribution of Kan and colleagues 4 is the quantitative description that allows others to recreate their design. This requires math to define conduit diameter, leaflet width, leaflet height, and the curves describing the leaflet attachment edge and free edge given the size of a patient's pulmonary artery.…”

“…7 A material like expanded polytetrafluoroethylene does not stretch appreciably under load (l ¼ 1), so the equation predicts that the leaflets in the closed and loaded state must have width 15% to 20% greater than the vessel diameter to meet at the valve center in the presence of this downward excursion. Kan and colleagues, 4 however, chose leaflet width equal to one-third of the vessel (conduit) perimeter, or pD/3, so we would expect the width of their leaflets in the valved conduit to be inadequate. They oversized the valved conduit by 10% to 20%, however, so that it is not fully opened in the pulmonary artery, and this provides the requisite amount of slack to allow the downward excursion of the closed leaflets.…”