# Pulmonary expanded polytetrafluoroethylene conduits with a hand-sewn tricuspid valve

## TL;DR

This study shows that a specific type of artificial heart conduit made from expanded polytetrafluoroethylene with a hand-sewn tricuspid valve has good long-term results in patients.

## Contribution

The study presents long-term clinical outcomes of a novel pulmonary conduit design with a hand-sewn tricuspid valve made from expanded polytetrafluoroethylene.

## Key findings

- The conduit showed 94% survival at 5 and 10 years with minimal valve-related issues.
- 24-mm conduits performed well in patients up to 75 kg for over 12 years post-surgery.
- Conduit replacements were mainly due to stenosis in smaller 18-mm conduits.

## Abstract

The biocompatibility of expanded polytetrafluoroethylene in the pulmonary position seems better than allogenic or xenogeneic reactivity. This study reviewed the application of pulmonary expanded polytetrafluoroethylene conduits having a hand-sewn tricuspid valve with diameters of 18–24 mm.

All patients receiving this conduit between 2010 and 2022 were evaluated. A 0.1-mm-thick membrane and a standard-wall tube of expanded polytetrafluoroethylene were used for cusp and conduit material, respectively.

Eighty-four consecutive patients were included. The median operative age and weight were 12 (range, 1.2–40) years and 34 (range, 9.1–82) kg, respectively. Eighteen-, 20-, 22- and 24-mm conduits were used in 19, 5, 3 and 57 patients, respectively. The overall survival was 94% at 5 and 10 years with four non-valve-related deaths. There were five conduit replacements, all for 18-mm conduit stenosis. Freedom from conduit replacement was 98% and 83% at 5 and 10 years, respectively. Freedom from conduit stenosis ≥ moderate was 83% and 54% at 5 and 10 years, respectively. Freedom from pulmonary regurgitation ≥ moderate was 98% at 5 and 10 years. Linear mixed-effects models with echocardiographic data implied that 24-mm conduits functioned with a peak velocity <3.0 m/s and without moderate/severe regurgitation in patients with a body weight of up to 75 kg and a body surface area of up to 2.0 m2 for >12 years postoperatively.

This conduit has shown favourable clinical outcomes and is a valid alternative, especially in young patients with increased risk for early failure of the existing products.

Right ventricular outflow tract (RVOT) reconstruction is essential for repairing various congenital heart defects.