Long-Term Outcomes With Expanded Polytetrafluoroethylene Valved Conduits in Pediatric Patients

The expanded polytetrafluoroethylene (ePTFE) valved conduit (VC) has been reported for pulmonary valve replacement (PVR). The purpose of this study was to review long-term outcomes of our trileaflet ePTFE VC.

This multicenter study was performed with institutional review board approval from each institution. Our VC is fashioned from commercially available ePTFE tube grafts (for the conduit) and 0.1-mm-thick ePTFE membrane (for the trileaflet material). The patients were followed up in our clinic. Valve function was assessed by echocardiography in the operating room and at follow-up clinic visits after implantation.

Fifty-five patients received ePTFE VC between 2012 and 2023 (16-28 mm in diameter). Patients' age at the time of implantation ranged from 6 months to 20 years (median, 7.5 years). Clinical follow-up ranged from 4 days to 10.1 years (average, 3.6 years). There were no hospital deaths. There were 2 non-valve-related late deaths. There have been no cases of endocarditis. Two patients required balloon dilation for the distal pulmonary artery stenosis, and 1 patient required residual ventricular septal defect closure. Five patients have received transcatheter PVR (TPVR) because of increased pressure gradient across the VC. Freedom from TPVR at 10 years was 90%. No valves required explantation or surgical replacement.

Compared with historical data for other PVR options, our ePTFE VC shows excellent long-term performance and, when required, provides an easily accessible "landing zone" for TPVR. Our technique is easily learned, is reproducible, and can be a valuable option for surgeons performing PVR in pediatric patients.