Key result
In children undergoing transannular repair of Tetralogy of Fallot, RVOT reconstruction with a PTFE monocusp resulted in a non-significant lower rate of moderate pulmonary regurgitation (11.8% vs 29.4%) compared to a bovine pericardial patch.
Why the study?
Early outcomes of polytetrafluoroethylene patch versus bovine pericardial patch for monocusp in right ventricular outflow tract reconstruction of TOF repair were not well compared.
Does right ventricular outflow tract reconstruction with a PTFE monocusp patch improve early postoperative outcomes compared to a bovine pericardial monocusp patch in children undergoing Tetralogy of Fallot repair?
Does right ventricular outflow tract reconstruction with a PTFE monocusp patch improve early postoperative outcomes compared to a bovine pericardial monocusp patch in children undergoing Tetralogy of Fallot repair?
In children undergoing Tetralogy of Fallot repair, PTFE and bovine pericardial monocusps yielded comparable early postoperative outcomes for right ventricular outflow tract reconstruction, though PTFE was associated with higher residual pressure gradients.
Answers are grounded in this paper and cite their sources.
Non-significant moderate PR difference with PTFE versus bovine monocusp in TOF repair warrants no practice change; leaves open optimal material selection in randomized trials.
Objective: To compare early outcomes of polytetrafluoroethylene patch (PTFE) versus bovine pericardial patch for monocusp in right ventricular outflow tract reconstruction of Tetralogy of Fallot (TOF) repair. Study design: Quasi-experimental study. Place and Duration of Study: Department of Paediatric and Congenital Cardiac Surgery, Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC-NIHD), Rawalpindi, Pakistan, from Jun 2024 to May 2025. Methodology: A total of 32 children aged ≤15 years, with transannular TOF were recruited through non-probability consecutive sampling and non-randomly allocated into groups based on the TOF repair technique: Group PTFE or Group bovine pericardial patch. All operative procedures were performed with median sternotomy under cardiopulmonary bypass (CPB) with moderate hypothermia. Early outcomes were compared between groups including peri-operative pulmonary regurgitation and residual right ventricular outflow tract pressure gradient (RVOT-PG), CPB time, aortic cross-clamp (ACC) time, ventilation time, Intensive Care Unit (ICU) stay and mortality. Results: Out of 32 patients, 19(58.80%) were male and 13(41.20%) were female while median age was 2.25 (6.50-1.58) years. Moderate pulmonary regurgitation (PR) was observed in 11.80% of the cases in PTFE group as compared to 29.40% of cases in Bovine group, however, this difference was not statistically significant (p>0.05) where RVOT-PG was significantly higher in the PTFE group (32.94±8.47 vs. 24.12±11.72 mmHg, p=0.01) on peri-operative echocardiogram. Conclusion: Similar early results were seen with RVOT reconstruction using PTFE and bovine pericardial monocusps, although it was statistically not significant, PTFE provided better protection against moderate pulmonary regurgitation.
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Majid et al. (2026) studied Tetralogy of Fallot (n=34). Polytetrafluoroethylene (PTFE) patch monocusp vs. Bovine pericardial patch monocusp was evaluated on Moderate pulmonary regurgitation (p=0.39). In children undergoing transannular repair of Tetralogy of Fallot, RVOT reconstruction with a PTFE monocusp resulted in a non-significant lower rate of moderate pulmonary regurgitation (11.8% vs 29.4%) compared to a bovine pericardial patch.
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