{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:48:24Z","timestamp":1793126904050,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To mitigate the shortage of homograft sources, the use of handmade trileaflet expanded polytetrafluoroethylene valves in pulmonary valve replacement has shown excellent results from multicentre studies conducted in Japan. However, world-wide data outside Japan are relatively insufficient. This study presents the long-term results of a single surgeon\u2019s use of flipped-back trileaflet method in a 10-year case series.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We have developed an efficient way to make a trileaflet-valved conduit utilizing flipped-back method for pulmonary valve replacement and have employed the technique since 2011. Retrospective data were studied between October 2010 and January 2020. Echocardiography, electrocardiogram, Pro-Brain Natriuretic Peptide and Magnetic Resonance Imaging data were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Fifty-five patients were reviewed and median follow-up duration was 2.9\u2009years. The majority of diagnoses was Tetralogy of Fallot (n\u2009=\u200941), and these patients subsequently underwent secondary pulmonary valve replacement at a median age of 15.6\u2009years. Survival was 92.7% with the longest follow-up period being 10\u2009years. There was no need for reoperation, and freedom from reintervention was 98.0% at 10\u2009years. There were 4 deaths (3 in-hospital and 1 outpatient). One patient eventually received transcatheter pulmonary valve implantation. Postoperative echocardiography showed mild or less pulmonary stenosis and pulmonary regurgitation degree in 92.2% and 92.0% of patients, respectively. Comparable magnetic resonance imaging data (n\u2009=\u200925) showed significant reduction in right ventricular volumes but not in ejection fractions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our series showed satisfactory long-term function of handmade flipped-back trileaflet-valved conduit used in our patients. The simple design is efficiently reproducible without complex fabrication process.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad120","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T14:13:22Z","timestamp":1679926402000},"source":"Crossref","is-referenced-by-count":6,"title":["Clinical outcomes of handmade polytetrafluoroethylene trileaflet-valved conduit used for pulmonary valve replacement"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8966-9012","authenticated-orcid":false,"given":"Te-I","family":"Chang","sequence":"first","affiliation":[{"name":"Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University , Taipei, Taiwan"},{"name":"Division of Cardiovascular Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University , Taipei, Taiwan"},{"name":"Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University , Taipei, Taiwan"},{"name":"Taipei Heart Institute, Taipei Medical University , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang-Hong","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Mackay Children\u2019s Hospital & Mackay Memorial Hospital , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1119-1968","authenticated-orcid":false,"given":"Wei-Li","family":"Hung","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Mackay Children\u2019s Hospital , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Jen","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Mackay Children\u2019s Hospital , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Ren","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Mackay Children\u2019s Hospital , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-San","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Mackay Memorial Hospital , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron-Bin","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Taiwan University Hospital, School of Medicine, National Taiwan University , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jou-Kou","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Taiwan University Hospital, School of Medicine, National Taiwan University , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2086-0097","authenticated-orcid":false,"given":"Ruey-Feng","family":"Chang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University , Taipei, Taiwan"},{"name":"Department of Computer Science and Information Engineering, National Taiwan University , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4730-4792","authenticated-orcid":false,"given":"Chung-I","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Mackay Children\u2019s Hospital & Mackay Memorial Hospital , Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,27]]},"reference":[{"key":"2023063021013185700_ezad120-B1","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1097\/00000658-195509000-00010","article-title":"Direct vision intracardiac surgical correction of the tetralogy of Fallot, pentalogy of Fallot, and pulmonary atresia defects; report of first ten cases","volume":"142","author":"Lillehei","year":"1955","journal-title":"Ann Surg"},{"key":"2023063021013185700_ezad120-B2","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1016\/S0735-1097(97)00318-5","article-title":"Long-term survival in patients with repair of tetralogy of Fallot: 36-year follow-up of 490 survivors of the first year after surgical repair","volume":"30","author":"Nollert","year":"1997","journal-title":"J Am Coll Cardiol"},{"key":"2023063021013185700_ezad120-B3","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1016\/j.athoracsur.2010.06.078","article-title":"Homografts and xenografts for right ventricular outflow tract reconstruction: long-term results","volume":"90","author":"Christenson","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"2023063021013185700_ezad120-B4","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1093\/eurheartj\/ehl033","article-title":"Long-term follow-up of homograft function after pulmonary valve replacement in patients with tetralogy of Fallot","volume":"27","author":"Oosterhof","year":"2005","journal-title":"Eur Heart J"},{"key":"2023063021013185700_ezad120-B5","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1016\/0003-4975(93)90700-R","article-title":"Outflow reconstruction of tetralogy of Fallot using a Gore-Tex valve","volume":"56","author":"Yamagishi","year":"1993","journal-title":"Ann Thorac Surg"},{"key":"2023063021013185700_ezad120-B6","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1093\/icvts\/ivaa302","article-title":"Evolution of pulmonary valve reconstruction with focused review of expanded polytetrafluoroethylene handmade valves","volume":"32","author":"Chang","year":"2021","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2023063021013185700_ezad120-B7","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.jtcvs.2007.03.030","article-title":"Expanded polytetrafluoroethylene valved conduit and patch with bulging sinuses in right ventricular outflow tract reconstruction","volume":"134","author":"Miyazaki","year":"2007","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023063021013185700_ezad120-B8","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.jtcvs.2008.08.060","article-title":"Ten-year experience with handmade trileaflet polytetrafluoroethylene valved conduit used for pulmonary reconstruction","volume":"137","author":"Ando","year":"2009","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023063021013185700_ezad120-B9","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1016\/j.jtcvs.2011.08.018","article-title":"Expanded polytetrafluoroethylene conduits and patches with bulging sinuses and fan-shaped valves in right ventricular outflow tract reconstruction: multicenter study in Japan","volume":"142","author":"Miyazaki","year":"2011","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023063021013185700_ezad120-B10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.athoracsur.2015.02.114","article-title":"Valved polytetrafluoroethylene conduits for right ventricular outflow tract reconstruction","volume":"100","author":"Shinkawa","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2023063021013185700_ezad120-B11","doi-asserted-by":"crossref","first-page":"2567","DOI":"10.1016\/j.jtcvs.2017.12.137","article-title":"Long-term outcomes of expanded polytetrafluoroethylene conduits with bulging sinuses and a fan-shaped valve in right ventricular outflow tract reconstruction","volume":"155","author":"Miyazaki","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023063021013185700_ezad120-B12","doi-asserted-by":"crossref","first-page":"e163","DOI":"10.1016\/j.athoracsur.2013.09.081","article-title":"An efficient way to make a trileaflet conduit for pulmonary valve replacement","volume":"96","author":"Chang","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2023063021013185700_ezad120-B13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ejechocard\/jen303","article-title":"Echocardiographic assessment of valve stenosis: EAE\/ASE recommendations for clinical practice","volume":"10","author":"Baumgartner","year":"2009","journal-title":"Eur J Echocardiogr"},{"key":"2023063021013185700_ezad120-B14","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1055\/s-0028-1096242","article-title":"Reconstruction of the right ventricular outflow tract including pulmonary valve replacement in 6 children under two years of age","volume":"27","author":"Oster","year":"1979","journal-title":"Thorac Cardiovasc Surg"},{"key":"2023063021013185700_ezad120-B15","first-page":"41","article-title":"Early degeneration of porcine xenograft valves in pediatric patients who have undergone apico-aortic bypass","volume":"9","author":"Chen","year":"1982","journal-title":"Tex Heart Inst J"},{"key":"2023063021013185700_ezad120-B16","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/1010-7940(93)90068-M","article-title":"Allograft degeneration in infant pulmonary valve allograft recipients","volume":"7","author":"Clarke","year":"1993","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023063021013185700_ezad120-B17","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/S0022-5223(96)70130-7","article-title":"Factors in the early failure of cryopreserved homograft pulmonary valves in children: preserved immunogenicity?","volume":"112","author":"Baskett","year":"1996","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023063021013185700_ezad120-B18","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.athoracsur.2004.05.045","article-title":"Initial experience with a bicuspid polytetrafluoroethylene pulmonary valve in 41 children and adults: a new option for right ventricular outflow tract reconstruction","volume":"79","author":"Quintessenza","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"2023063021013185700_ezad120-B19","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/j.ejcts.2005.01.060","article-title":"Long-term outcome of right ventricular outflow tract reconstruction using a handmade tri-leaflet conduit","volume":"27","author":"Koh","year":"2005","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023063021013185700_ezad120-B20","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1510\/icvts.2006.143479","article-title":"An expanded polytetrafluoroethylene-autologous aortic hybrid valve for right ventricular outflow tract reconstruction in the Ross procedure","volume":"6","author":"Miyazaki","year":"2006","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2023063021013185700_ezad120-B21","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s11748-009-0527-9","article-title":"Expanded polytetrafluoroethylene-valved conduit with bulging sinuses for right ventricular outflow tract reconstruction in adults","volume":"58","author":"Takahashi","year":"2010","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"2023063021013185700_ezad120-B22","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.1016\/j.athoracsur.2012.12.047","article-title":"A new simplified technique for making tricuspid expanded polytetrafluoroethylene valved conduit for right ventricular outflow reconstruction","volume":"95","author":"Kim","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2023063021013185700_ezad120-B23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s11748-014-0500-0","article-title":"Current status of right ventricular outflow tract reconstruction: complete translation of a review article originally published in Kyobu Geka 2014;67:65-77","volume":"63","author":"Yamamoto","year":"2015","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"2023063021013185700_ezad120-B24","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.athoracsur.2017.07.013","article-title":"Medium-term outcomes after implantation of expanded polytetrafluoroethylene valved conduit","volume":"105","author":"Ootaki","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2023063021013185700_ezad120-B25","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1093\/icvts\/ivz274","article-title":"In vitro study of trileaflet polytetrafluoroethylene conduit and its valve-in-valve transformation","volume":"30","author":"Chang","year":"2020","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2023063021013185700_ezad120-B26","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.amjcard.2004.11.037","article-title":"Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair","volume":"95","author":"Therrien","year":"2005","journal-title":"Am J Cardiol"},{"key":"2023063021013185700_ezad120-B27","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1093\/ejcts\/ezs381","article-title":"Bicuspid pulmonary valve implantation using polytetrafluoroethylene membrane: early results and assessment of the valve function by magnetic resonance imaging","volume":"43","author":"Lee","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023063021013185700_ezad120-B28","doi-asserted-by":"crossref","first-page":"e010852","DOI":"10.1161\/CIRCINTERVENTIONS.121.010852","article-title":"Long-term outcomes after melody transcatheter pulmonary valve replacement in the US investigational device exemption trial","volume":"15","author":"Jones","year":"2022","journal-title":"Circ Cardiovasc Interv"},{"key":"2023063021013185700_ezad120-B29","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1016\/j.jtcvs.2014.05.083","article-title":"Handmade trileaflet valved stent graft for pulmonary valve implantation","volume":"148","author":"Lin","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023063021013185700_ezad120-B30","doi-asserted-by":"crossref","first-page":"e541","DOI":"10.1016\/j.athoracsur.2016.04.093","article-title":"Successful transcatheter handmade-valved graft stent for branch pulmonary regurgitation: novel approach in a special event","volume":"102","author":"Lin","year":"2016","journal-title":"Ann Thorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezad120\/49650403\/ezad120.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/6\/ezad120\/50775689\/ezad120.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/6\/ezad120\/50775689\/ezad120.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T21:44:17Z","timestamp":1688161457000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezad120\/7087104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,27]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezad120","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,6,1]]},"published":{"date-parts":[[2023,3,27]]},"article-number":"ezad120"}}