TITLE:
Polytetrafluoroethylene Patch versus Autologous Pericardial Patch for Right Ventricular Outflow Tract Reconstruction in Patients with Tetralogy of Fallot
AUTHORS:
Sachin Talwar, Intekhab Alam, Vishnubhatla Srreenivas, Palleti Rajashekar, Sivasubramanian Ramakrishnan, Shiv Kumar Choudhary, Balram Airan
KEYWORDS:
Tetralogy of Fallot, Right Ventricular Outflow Tract, Patch Material
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.7 No.3,
March
31,
2017
ABSTRACT: Objective: For patients of TOF with pulmonary
annular hypoplasia, reconstruction of right ventricular outflow tract (RVOT)
often requires a trans annular patch (TAP). The present study aims to compare
the outcomes of TOF repair using Polytetrafluoroethylene (PTFE) patch versus
autologous glutaraldehyde fixed pericardial patch for RVOT reconstruction. Materials
and methods: 103 consecutive patients undergoing TOF repair in whom TAP was
required were randomized into two groups: Group I (pericardial patch), Group II (PTFE patch). Postoperative outcomes in
terms of postoperative heart rhythm, duration of mechanical ventilation,
mediastinal and pleural drainage, length
of stay in intensive care unit (ICU) and hospital mortality were assessed. A
separate team of cardiologists independently evaluated pre- and post-operative
gradients across the RVOT, degree of pulmonary insufficiency, right ventricular
systolic function. Results: There were no significant differences between the
two groups in terms of the incidence of postoperative arrhythmias, duration of
mechanical ventilation, length of intensive care unit or hospital stay. The
requirement of inotropes was no different in the PTFE patch group as compared with
the pericardial patch group (16.84 ± 7.04 vs. 17.90 ± 6.71, median 19 vs. 20, p
= 0.825). The re-exploration rate was higher in the PTFE group as compared with
the pericardial patch group (6 vs. 1). Postoperative Echocar-diography revealed
no differences in the RV systolic function between the two groups before
discharge. Conclusion: In patients undergoing TOF repair, using a PTFE patch
yields comparable results. However, the efficacy of PTFE will only be
established once; mid-term and long-term results are available.