Key result
ePTFE trileaflet valved conduits are linked to zero conduit failures versus ~13% with autologous pericardium.
Why the study?
The comparative efficacy and safety between 0.1 mm ePTFE and autologous pericardium in hand-sewn trileaflet valved conduits remained undetermined.
Does 0.1 mm ePTFE reduce the incidence of graft failure and dysfunction compared to autologous pericardium in pediatric patients receiving hand-sewn trileaflet valved conduits?
Cohort (n=46)
No
Does 0.1 mm ePTFE reduce the incidence of graft failure and dysfunction compared to autologous pericardium in pediatric patients receiving hand-sewn trileaflet valved conduits?
In pediatric patients, 0.1 mm ePTFE hand-sewn trileaflet valved conduits appear to be associated with a lower incidence of graft failure and dysfunction compared to autologous pericardium.
Answers are grounded in this paper and cite their sources.
ePTFE conduits associated with lower 3-year graft failure; leaves open need for randomized trials before practice change.
A hand-sewn trileaflet valved conduit is reportedly better than a bovine jugular graft. However, the comparative efficacy and safety between 0.1 mm ePTFE and autologous pericardium in this surgical procedure remained undetermined. This single-center cohort study included 46 patients aged 3-146 months who received implanted simplified hand-sewn trileaflet valved conduits: 31 patients (Group A) received 0.1 mm ePTFE valved conduits and 15 patients (Group B) received autologous pericardium valved conduits. Perioperative and follow-up outcomes up to 3 years after the surgeries were evaluated. No perioperative complications or early mortality were observed in either group, while one Group A patient aged 46 months died 6 months after surgery due to residual ventricular septal defect. No patients in Group A developed severe regurgitation or stenosis in valves of the conduits, but two moderate stenosis by echocardiography, and seven patients in group B were deemed to be conduit dysfunction (two stenosis, three stenosis plus regurgitation, and the remaining two regurgitation). No conduits failure was detected in group A, while two patients in group B (one for severe stenosis and the other one for severe regurgitation). After 6, 12, and 36 months, 95.2%, 88.9%, and 88.9% of Group A patients and 92.3%, 68.4%, and 42.7% of Group B patients were free from valved conduit dysfunction. After the same follow-up periods, all Group A patients had no conduit failure and 92.3%, 80.8%, and 80.8% of Group B patients were free from valved conduit failure. Within the 3-year follow-up period, 0.1 mm ePTFE novel simplified hand-sewn trileaflet valved conduits appear to be associated with a lower incidence of graft failure than autologous pericardium valved conduits.
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Zhang et al. (2019) conducted a cohort in Right-ventricular outflow tract (RVOT) reconstruction (n=46). 0.1 mm ePTFE valved conduits vs. Autologous pericardium valved conduits was evaluated on Conduit failure (p=0.038). 0.1 mm ePTFE hand-sewn trileaflet valved conduits reduced the incidence of conduit failure compared to autologous pericardium valved conduits.
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