Modified Hand-Sewn Polytetrafluoroethylene Bicuspid Valved Conduit for the Reconstruction of Right Ventricle Outflow Tract in Truncus Arteriosus in Infancy: A Case Report

Authors

  • Jianrui Ma Shantou University Medical College, 515041 Shantou, Guangdong, China; Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Hailong Qiu Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Miao Tian Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Wen Xie Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Ying Li Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Zichao Tujia Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Tong Tan Shantou University Medical College, 515041 Shantou, Guangdong, China; Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China; Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, 100029 Beijing, China
  • Linjiang Han Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Ziqin Zhou Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Shusheng Wen Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Jimei Chen Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Jian Zhuang Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Haiyun Yuan Shantou University Medical College, 515041 Shantou, Guangdong, China; Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Xiaobing Liu Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China

DOI:

https://doi.org/10.59958/hsf.6383

Keywords:

truncus arteriosus, right ventricle outflow tract reconstruction, polytetrafluoroethylene, valved conduit, technique

Abstract

The reconstruction of the right ventricle outflow tract in truncus arteriosus remains challenging. The use of valved conduit based on polytetrafluoroethylene has been increasingly popular since the 1990s. Albeit with verified long-term durability, the previous techniques for manufacturing polytetrafluoroethylene valved conduit were relatively cumbersome and time-cost, which at least in part limited its further application. We reported the first successful truncus arteriosus case using a modified and simplified technique for hand-sewing the polytetrafluoroethylene pulmonary bicuspid valved conduit. Eventually, the patient completed the surgery successfully and showed a satisfactory outcome during the 17-month follow-up. Therefore, this technique is a time-saving, reproducible, and reliable approach in truncus arteriosus on the reconstruction of the right ventricle outflow tract.

References

Naimo PS, Konstantinov IE. Surgery for Truncus Arteriosus: Contemporary Practice. The Annals of Thoracic Surgery. 2021; 111: 1442–1450.

Curi-Curi P, Cervantes J, Soulé M, Erdmenger J, Calderón-Colmenero J, Ramírez S. Early and midterm results of an alternative procedure to homografts in primary repair of truncus arteriosus communis. Congenital Heart Disease. 2010; 5: 262–270.

Herrmann JL, Larson EE, Mastropietro CW, Rodefeld MD, Turrentine MW, Nozaki R, et al. Right Ventricular Outflow Tract Reconstruction in Infant Truncus Arteriosus: A 37-year Experience. The Annals of Thoracic Surgery. 2020; 110: 630–637.

Yamagishi M, Kurosawa H. Outflow reconstruction of tetralogy of Fallot using a Gore-Tex valve. The Annals of Thoracic Surgery. 1993; 56: 1414–1417.

Seese LM, Turbendian HK, Castrillon CED, Morell VO. The Fate of Homograft Versus Polytetrafluoroethylene Conduits After Neonatal Truncus Arteriosus Repair. World Journal for Pediatric & Congenital Heart Surgery. 2020; 11: 141–147.

Mercer CW, West SC, Sharma MS, Yoshida M, Morell VO. Polytetrafluoroethylene conduits versus homografts for right ventricular outflow tract reconstruction in infants and young children: An institutional experience. The Journal of Thoracic and Cardiovascular Surgery. 2018; 155: 2082–2091.e1.

Miyazaki T, Yamagishi M, Maeda Y, Taniguchi S, Fujita S, Hongu H, et al. Long-term outcomes of expanded polytetrafluoroethylene conduits with bulging sinuses and a fan-shaped valve in right ventricular outflow tract reconstruction. The Journal of Thoracic and Cardiovascular Surgery. 2018; 155: 2567–2576.

Buckley JR, Amula V, Sassalos P, Costello JM, Smerling AJ, Iliopoulos I, et al. Multicenter Analysis of Early Childhood Outcomes After Repair of Truncus Arteriosus. The Annals of Thoracic Surgery. 2019; 107: 553–559.

Sinzobahamvya N, Boscheinen M, Blaschczok HC, Kallenberg R, Photiadis J, Haun C, et al. Survival and reintervention after neonatal repair of truncus arteriosus with valved conduit. European Journal of Cardio-thoracic Surgery: Official Journal of the European Association for Cardio-thoracic Surgery. 2008; 34: 732–737.

Hongu H, Yamagishi M, Maeda Y, Itatani K, Fujita S, Nakatsuji H, et al. Expanded Polytetrafluoroethylene Conduits With Bulging Sinuses and a Fan-Shaped Valve in Right Ventricular Outflow Tract Reconstruction. Seminars in Thoracic and Cardiovascular Surgery. 2022; 34: 972–980.

Sharifulin R, Bogachev-Prokophiev A, Demin I, Zheleznev S, Pivkin A, Afanasyev A, et al. Right ventricular outflow tract reconstruction using a polytetrafluoroethylene conduit in Ross patients. European Journal of Cardio-thoracic Surgery: Official Journal of the European Association for Cardio-thoracic Surgery. 2018; 54: 427–433.

Quintessenza JA, Jacobs JP, Morell VO, Giroud JM, Boucek RJ. Initial experience with a bicuspid polytetrafluoroethylene pulmonary valve in 41 children and adults: a new option for right ventricular outflow tract reconstruction. The Annals of Thoracic Surgery. 2005; 79: 924–931.

Diaz-Castrillon CE, Castro-Medina M, Viegas M, Lewis J, Hyzny E, Tarun S, et al. Anatomic Position and Durability of Polytetrafluoroethylene Conduit ≥18 mm: Single-Center Experience. The Annals of Thoracic Surgery. 2023; 115: 983–989.

Mery CM, Guzmán-Pruneda FA, De León LE, Zhang W, Terwelp MD, Bocchini CE, et al. Risk factors for development of endocarditis and reintervention in patients undergoing right ventricle to pulmonary artery valved conduit placement. The Journal of Thoracic and Cardiovascular Surgery. 2016; 151: 432–432–9, 441.e1–2.

Albanesi F, Sekarski N, Lambrou D, Von Segesser LK, Berdajs DA. Incidence and risk factors for Contegra graft infection following right ventricular outflow tract reconstruction: long-term results. European Journal of Cardio-thoracic Surgery: Official Journal of the European Association for Cardio-thoracic Surgery. 2014; 45: 1070–1074.

Yuan SM, Mishaly D, Shinfeld A, Raanani E. Right ventricular outflow tract reconstruction: valved conduit of choice and clinical outcomes. Journal of Cardiovascular Medicine (Hagerstown, Md.). 2008; 9: 327–337.

Dave H, Mueggler O, Comber M, Enodien B, Nikolaou G, Bauersfeld U, et al. Risk factor analysis of 170 single-institutional contegra implantations in pulmonary position. The Annals of Thoracic Surgery. 2011; 91: 195–195–303.

Padalino MA, Çelmeta B, Vedovelli L, Castaldi B, Vida VL, Stellin G. Alternative techniques of right ventricular outflow tract reconstruction for surgical repair of truncus arteriosus. Interactive Cardiovascular and Thoracic Surgery. 2020; 30: 910–916.

Published

2024-02-27

How to Cite

Ma, J., Qiu, H., Tian, M., Xie, W., Li, Y., Tujia, Z., Tan, T., Han, L., Zhou, Z., Wen, S., Chen, J., Zhuang, J., Yuan, H., & Liu, X. (2024). Modified Hand-Sewn Polytetrafluoroethylene Bicuspid Valved Conduit for the Reconstruction of Right Ventricle Outflow Tract in Truncus Arteriosus in Infancy: A Case Report. The Heart Surgery Forum, 27(3), E199-E205. https://doi.org/10.59958/hsf.6383

Issue

Vol. 27 No. 3 (2024)

Section

Case Report
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