Right ventricular outflow tract reconstruction using a polytetrafluoroethylene conduit in Ross patients†

Abstract

The type of conduit used for right ventricular outflow tract (RVOT) reconstruction during the Ross procedure remains problematic because of the limited availability of pulmonary allografts and the unsatisfactory long-term results associated with the use of xenografts. Polytetrafluoroethylene (PTFE) conduits have been proposed as an alternative. This study evaluated the results of RVOT reconstruction using a PTFE conduit during the Ross procedure. Between 2007 and 2015, 28 patients underwent RVOT reconstruction using PTFE conduits. The mean age of the patients was 35.9 ± 18.1 (range 4-58) years. The total root replacement technique was used in all patients. The mean PTFE conduit size was 25.3 ± 2.3 mm. The early mortality rate was 3.6% (1 patient). The mean follow-up duration was 48.5 ± 31.2 months; there were no late deaths. The transprosthetic gradients increased significantly over time. The conduit size was the only independent predictor of peak RVOT gradient progression (P = 0.02). None of the patients demonstrated significant RVOT regurgitation. One patient required an RVOT reoperation. The PTFE conduit demonstrates acceptable haemodynamic results at the mid-term follow-up and could be considered as an alternative substitute for RVOT reconstruction during the Ross procedure.