Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan.
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan.
Ann Thorac Surg. 2021 Sep;112(3):831-837. doi: 10.1016/j.athoracsur.2020.06.119. Epub 2020 Sep 16.
Excellent outcomes of right ventricle to pulmonary artery conduits with expanded polytetrafluoroethylene (ePTFE) valves have been reported. The purpose of this study was to evaluate the outcomes of the different material conduits with tricuspid ePTFE valves.
Forty-one consecutive patients who received right ventricle to pulmonary artery conduit with tricuspid ePTFE valves for biventricular repair between April 2004 and December 2016 were studied. The conduits made of autologous pericardial roll or xenograft roll were used in 22 patients (group P) and the conduits made of ePTFE tube were used in 19 patients (group G). The conduit reoperation and the conduit dysfunction were analyzed.
During the median follow-up of 5.8 years, no death related to the conduit was observed. There were four reoperations (three in group P and one in group G). Freedom from conduit reoperation at 5 years was 100% in both groups (P = .30). Freedom from more than moderate conduit stenosis at 5 years after operation was not significantly different between groups (46.9% in group P vs 76.3% in group G, P = .23) even though the group G conduits were significantly smaller and freedom from more than moderate conduit regurgitation at 5 years was significantly better in group G (63.3% in group P vs 94.1% in group G, P = .04).
The conduit with ePTFE valves in the ePTFE tubes had better conduit function compared with the conduit with autologous pericardial or xenograft roll, especially in terms of conduit regurgitation.
带三尖瓣膨体聚四氟乙烯（ePTFE）瓣的右心室至肺动脉管道具有优异的结果已被报道。本研究的目的是评估带三尖瓣 ePTFE 瓣的不同材料管道的结果。
2004 年 4 月至 2016 年 12 月，41 例连续接受右心室至肺动脉带三尖瓣 ePTFE 瓣的患者接受了双心室修复术。22 例患者（P 组）使用自体心包卷或异种移植物卷制成的管道，19 例患者（G 组）使用 ePTFE 管制成的管道。分析了管道再手术和管道功能障碍的情况。
在中位随访 5.8 年期间，未观察到与管道相关的死亡。有 4 例再手术（P 组 3 例，G 组 1 例）。两组患者的管道再手术率在 5 年内均为 100%（P=0.30）。术后 5 年时，两组中度以上管道狭窄的发生率无显著差异（P 组 46.9%，G 组 76.3%，P=0.23），尽管 G 组的管道明显较小，5 年时中度以上管道反流的发生率明显优于 P 组（P 组 63.3%，G 组 94.1%，P=0.04）。
与自体心包或异种移植物卷制成的管道相比，ePTFE 管制成的带 ePTFE 瓣的管道具有更好的管道功能，特别是在管道反流方面。
