Decision-making to use right ventricle to pulmonary artery conduit: Advantages of the expanded polytetrafluoroethylene valved conduit

Abstract

It is desirable to preserve the pulmonary valve annulus as much as possible, but the decision to preserve the annulus should be made by taking into account not only the annulus diameter but also the characteristics of the valve leaflets. Even if the valve annulus diameter is 70% or more of the normal value, in cases where the valve leaflets are poorly mobile or thickened, there is a concern that pulmonary regurgitation will worsen after pulmonary commissurotomy, so it is desirable to reconstruct the right ventricular outflow tract using a valved conduit in order to preserve right ventricular function. The choice of conduit is extremely important. The bovine jugular vein graft, which is associated with a high incidence of complications such as infection, should be avoided as much as possible. The ePTFE valved conduit is useful for preserving right ventricular function, and is recommended as a conduit for right ventricular outflow tract reconstruction. Although ePTFE valved conduits may cause relative stenosis due to weight gain, the possibility of pulmonary regurgitation is low, and the frequency of thrombosis and infection is also low. The conduit exchange free rate for large-diameter ePTFE valved conduits is high, and the need for reintervention is low.