A 10-mm Monocusp Expanded Polytetrafluoroethylene Valved Conduit for Right Ventricular Outflow Tract Reconstruction in Neonates and Young Infants.

Abstract

BackgroundCurrently, no ideal prosthesis is available for right ventricular outflow tract (RVOT) reconstruction in neonates and young infants. Therefore, we developed a 10-mm handmade monocusp expanded polytetrafluoroethylene (ePTFE) valved conduit and report our experience.MethodsA retrospective clinical review was conducted on 11 consecutive patients who underwent RVOT reconstruction with a 10-mm handmade monocusp ePTFE valved conduit since May 2018. Six patients underwent a definitive Rastelli operation, and five underwent palliative right ventricle-to-pulmonary artery conduit formation. The median age at the time of operation was 61 (range, 6-462; interquartile range [IQR]: 229) days, and the median weight was 4.0 (range, 3.0-11.6; IQR: 4.3) kg.ResultsOne patient died early due to brain hemorrhage, and one died late due to sepsis. The follow-up duration was 38.5 ± 18.9 months. The mean peak pressure gradients across the conduit were 6.5 ± 4.4 mm Hg at discharge and 22.0 ± 11.2 mm Hg at the latest follow-up echocardiography. Regarding conduit regurgitation, all conduits showed better than moderate grading at the last follow-up or before reintervention. There were seven conduit explantations and three catheter interventions for conduit-related reasons. The explantations included a definitive Rastelli operation in three patients and conduit stenosis due to somatic growth in four patients.ConclusionOur simple 10-mm handmade monocusp ePTFE valved conduit demonstrated satisfactory clinical outcomes and is be a suitable option for RVOT reconstruction in neonates and young infants.