Expanded polytetrafluoroethylene monocuspid valve for right ventricular outflow tract reconstruction

Background. Numerous materials have been used for reconstruction of the right ventricular outflow tract (RVOT) in patients with complex congenital heart defects. Methods. Between January 1982 and March 1999, 19 patients (10 boys and 9 girls; mean age, 8.5 years) with severe RVOT obstruction underwent reconstruction 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 showed good motion of all cusps, and most had no or trivial pulmonary regurgitation. The difference between the preoperative and postoperative mean ratio of right-to-left ventricular peak systolic pressure was significant (p = 0.0001). In the 8 patients followed for 3 years or longer, pulmonary regurgitation 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 the monocusps. Two patients needed reoperation because of stenosis at the distal anastomosis of the transannular patch; 1 patient died. Conclusions. The ePTFE monocuspid valve may be useful in reconstruction of the RVOT.