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Handmade tri-leaflet ePTFE conduits versus homografts for right ventricular outflow tract reconstruction

World Journal of Pediatrics 2022年第3期18卷 206-213页

作者： Guan-Xi Wang Feng-Qun Mao Kai Ma Rui Liu Kun-Jing Pang Sen Zhang Yang Yang Ben-Qing Zhang Shou-Jun Li National Center for Cardiovascular Diseases Pediatric Cardiac CenterFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeNo.167 Beilishi StreetXicheng DistrictBeijing 100037China Department of Echocardiography National Center for Cardiovascular DiseasesFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeNo.167 Beilishi StreetXicheng DistrictBeijing 100037China Department of Pediatric Cardiac Surgery Fuwai HospitalChinese Academy of Medical SciencesPeking Union Medical College167 Beilishi RoadXicheng DistrictBeijing 100037China

Background This study aimed to investigate the performance of handmade tri-leaflet expanded polytetrafluoroethylene(ePTFE)conduits in the absence of a suitable *** Patients who underwent right ventricular outflow tract reconstruction with tri-leaflet ePTFE conduits or homografts between December 2016 and August 2020 were *** primary endpoint was the incidence of moderate or severe conduit stenosis(>36 mmHg)and/or moderate or severe *** secondary endpoint was the incidence of severe conduit stenosis(>64 mmHg)and/or severe *** There were 102 patients in the ePTFE group and 52 patients in the homograft *** median age was younger[34.5(interquartile range:20.8-62.8)vs.60.0(interquartile range:39.3-81.0)months,P=0.001]and the median weight was lower[13.5(10.0-19.0)vs.17.8(13.6-25.8)kg,P=0.003]in the ePTFE *** conduit size was smaller(17.9±2.2 vs.20.5±3.0 mm,P<0.001)and the conduit Z score was lower(1.48±1.04 vs.1.83±1.05,P—0.048)in the ePTFE *** was no significant difference in the primary endpoints(log rank,T3=0.33)and secondary endpoints(log rank,P=0.35).Multivariate analysis identified lower weight at surgery[P=0.01;hazard ratio:0.75;95%confidence interval(CI)0.59-0.94]and homograft conduit use(P=0.04;hazard ratio:8.43;95%CI 1.14—62.29)to be risk factors for moderate or severe conduit *** risk factors were found for moderate or severe conduit stenosis or conduit dysfunction on multivariate *** Handmade tri-leaflet ePTFE conduits showed acceptable early and midterm outcomes in the absence of a suitable homograft,but a longer follow-up is needed.

关键词： Expanded polytetrafluoroethylene conduit Homograft right ventricular outflow tract reconstruction

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