Expanded polytetrafluoroethylene monocuspid valve for right ventricular outflow tract reconstruction

Background. Numerous materials have been used for reconstruction of the rig ht ventricular outflow tract (RVOT) in patients with complex congenital hea rt defects. Methods. Between January 1982 and March 1999, 19 patients (10 boys and 9 gi rls; mean age, 8.5 years) with severe RVOT obstruction underwent reconstruc tion using a transannular patch and expanded polytetrafluoroethylene (ePTFE ) monocuspid valve. Results. There were no perioperative deaths. Postoperatively, the mean +/- standard deviation RVOT gradient was 12 +/- 9 mm Hg. Echocardiography showe d good motion of all cusps, and most had no or trivial pulmonary regurgitat ion. The difference between the preoperative and postoperative mean ratio o f right-to-left ventricular peak systolic pressure was significant (p = 0.0 001). In the 8 patients followed for 3 years or longer, pulmonary regurgita tion was mild or better in 5 and moderate in 2, and the mean peak systolic RVOT gradient was 16.3 +/- 5.9 mm Hg. Five patients had good mobility of th e monocusps. Two patients needed reoperation because of stenosis at the dis tal anastomosis of the transannular patch; 1 patient died. Conclusions. The ePTFE monocuspid valve may be useful in reconstruction of the RVOT. (Ann Thorac Surg 2000;70:1511-4) (C) 2000 by The Society of Thora cic Surgeons.