PTFE Valved Conduits: Moving From Why? to Why Not?

I enjoyed reading the study by Diaz-Castrillon and colleagues 1 Diaz-Castrillon C.E. Viegas M. Castro-Medina M. et al. Pulmonary homograft vs handmade polytetrafluoroethylene-valved conduits after the Ross procedure. Ann Thorac Surg. 2023; 116: 980-987 Abstract Full Text Full Text PDF Scopus (1) Google Scholar in this issue of The Annals of Thoracic Surgery comparing midterm outcomes for hand-sewn expanded polytetrafluoroethylene (ePTFE) valved conduits (n = 60) vs pulmonary homograft (n = 30) for right ventricular outflow tract reconstruction in Ross patients. The authors of this study were well poised to make this comparison as they have arguably the largest North American experience with hand-sewn ePTFE valved conduits for Ross patients. During the follow-up time, the authors found no difference in the need for conduit reintervention between conduit types. They also found that conduit type was not associated with an increased hazard for surgical replacement, and they found no difference in the evolution of gradient or the development of moderate to severe regurgitation over time. Their reported rates of 5-year freedom from ePTFE conduit reintervention and surgical replacement (87% and 92%, respectively) are better than or equivalent to those reported in other large series of Ross patients in whom pulmonary homograft was used preferentially. Pulmonary Homograft vs Handmade Polytetrafluoroethylene-Valved Conduits After the Ross ProcedureThe Annals of Thoracic SurgeryVol. 116Issue 5PreviewThis study aimed to longitudinally compare expanded polytetrafluoroethylene (ePTFE)–valved conduits vs pulmonary homograft (PH) conduits after right ventricular outflow tract reconstruction in the Ross procedure. Full-Text PDF