Valve-containing conduit with Valsalva sinuses made of foamed polytetrafluoroethylene for reconstruction of the outflow pathway from the right ventricle

• Petshakovskiy P.J.
• Porkhanov V.A.
• Boriskov M.V.
• Efimochkin G.A.
• Vanin O.A.
• Iofe E.I.
• Pereverzeva A.A.
• Tkachenko I.A.

Abstract

Background. When reconstructing the outflow pathway from the right ventricle of the heart, it is preferable to use valve-containing conduits. The locking element of the prosthesis prevents volumetric overload and, as a result, dilation of the right ventricle. Currently, there are no ideal valve conduits, and the long-term results of existing biological prostheses are unsatisfactory. An alternative may be valve-containing polytetrafluoroethylene (ePTFE) foam conduits, created manually individually for each patient. In this article, we want to present our method of manufacturing a synthetic valve-containing conduit with Valsalva sinuses from ePTFE.

Material and methods. At the Scientific Research Institute – Regional Clinical Hospital # 1, a tricuspid valve-containing conduit made of ePTFE with Valsalva sinuses was developed and put into practice to reconstruct the outflow pathway from the right ventricle. Geometrically, the conduit completely repeats the anatomical shape of the root of the human main vessel, i.e. there is a fibrous ring, Valsalva sinuses, sinotubular junction. There are three symmetrical semilunar flaps inside the sinuses.

Results. During the period from December 2019 to February 2024, 21 patients underwent reconstruction of the outflow pathway from the right ventricle with a valve-containing conduit from ePTFE. There were no deaths in the immediate and medium-term postoperative period. No thrombosis or destruction of the valve of the device was recorded, which was confirmed by studies using ultrasound cardiography and 3D computed tomography.

Conclusion. The average long-term results of using ePTFE conduit in the pulmonary position in our series of patients are satisfactory. The conduit material is easy to manufacture, always available. It is bioinert, non-degradable, atrombogenic and practically not calcified, which will increase freedom from re-operation.

Keywords:reconstruction of the outflow pathway from the right ventricle; conduit; polytetrafluoroethylene

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