Mid-Term Durability of Tissue-Engineered Vascular Graft Patches for Pulmonary Artery Reconstruction

Autologous pericardium is commonly used for pulmonary artery (PA) reconstruction in congenital heart surgery but is not always available. Synthetic materials lack growth potential and may cause calcification or infection. Tissue-engineered vascular grafts (TEVGs), created by in-body tissue architecture, may overcome these limitations. This study evaluated mid-term outcomes of PA reconstruction using TEVG patches. From July 2014 to December 2024, TEVG molds were implanted in 19 patients; seven underwent PA reconstruction using 15 patches. Diagnoses included pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (n = 4), coarctation with aortic stenosis (n = 1), double outlet right ventricle with coarctation (n = 1), and tetralogy of Fallot (n = 1). Median follow-up was 2.8 years (range, 1.0-7.9 years). No mortality or patch-related calcification, aneurysm, or infection occurred. Restenosis developed in three of 15 patches (20%), all in the central PA near the right ventricle-to-PA conduit anastomosis; two patients required balloon angioplasty, with no surgical reintervention. No restenosis occurred in peripheral patches. Freedom from reintervention was 85.7% at 1 year and 71.4% at 5 years. TEVG patches demonstrated acceptable durability, particularly for peripheral PA augmentation, and may represent a reliable alternative to autologous pericardium.