Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension Secondary to Expanded Polytetrafluoroethylene Valved Pulmonary Conduit Thrombosis

Background: There is no consensus on the preferred conduit for right ventricular outflow tract (RVOT) reconstruction for congenital cardiac disease. Case summary: We present a case of a 21-year-old woman with history of tetralogy of Fallot presenting with recurrent graft thrombosis and pulmonary emboli in the setting of RVOT reconstruction with a 20-mm expanded polytetrafluoroethylene (ePTFE) valved conduit (GORE PV1, W.L. Gore & Associates). A diagnosis of chronic thromboembolic pulmonary hypertension was made, and the patient underwent pulmonary endarterectomy and conduit exchange with a pulmonary homograft. Discussion: The novelty and clinical significance of this report lies in the confirmation of thrombosis of a large-diameter ePTFE valved pulmonary conduit (20 mm) and its implications for monitoring and need for further optimization of thromboprophylaxis strategies in this population.