August 2025

CARDIOVASCULAR

ADDRESSING THROMBOSIS IN EPTFE VALVED PULMONARY CONDUITS: A CASE STUDY ON PULMONARY ENDARTERECTOMY FOR CTEPH MANAGEMENT

A recent case study, published in JACC Journals: JACC Case Reports, examines the challenges of managing CTEPH associated with a large-diameter expanded polytetrafluoroethylene (ePTFE) valved pulmonary conduit in a young woman with a history of tetralogy of Fallot.

Case Overview
The 21-year-old patient presented with recurrent graft thrombosis and pulmonary emboli following multiple surgical interventions for congenital heart disease. After multiple failed conduits, the patient underwent right ventricular outflow tract reconstruction with a 20-millimeter ePTFE valve conduit.
She was diagnosed with CTEPH due to thrombosis and underwent pulmonary endarterectomy and conduit exchange with a pulmonary homograft.

Key Findings and Clinical Implications
The report highlights the need for careful monitoring and adjusted thromboprophylaxis strategies. It emphasizes that the choice of conduits for right ventricular outflow tract reconstruction can have far-reaching implications for patient outcomes, specifically regarding the risk of thrombosis and subsequent CTEPH.
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Thrombosis in ePTFE valved conduits is a critical concern that may compromise long-term outcomes. There is a need for more research into optimizing anticoagulation therapy and understanding the complexities surrounding conduit selection in congenital heart disease.

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