Back to Search
Start Over
Transcatheter Versus Surgical Pulmonary Valve Replacement: A Systemic Review and Meta-Analysis
- Source :
- The Annals of thoracic surgery. 110(5)
- Publication Year :
- 2020
-
Abstract
- Background Transcatheter pulmonary valve replacement (TPVR) has emerged as an alternative to surgery in patients with pulmonary valve dysfunction. Methods We searched the Medline and Cochrane databases since their inception to January 2019 as well as references from article, for all publications comparing TPVR with surgical PVR (SPVR). Studies were considered for inclusion if they reported comparative data regarding any of the study endpoints. The primary endpoint was early mortality after PVR. Secondary endpoints included procedure-related complications, length of hospital stay, mortality during follow-up, infective endocarditis, need for reintervention, post-PVR transpulmonary peak systolic gradient, and significant pulmonary regurgitation. Results There were no differences in perioperative mortality between groups (0.2% vs 1.2%; pooled odds ratio, 0.56; 95% confidence interval, 0.19-1.59; P = .27, I2 = 0%). However TPVR conferred a significant reduction in procedure-related complications and length of hospital stay compared with SPVR. Midterm mortality and the need for repeat intervention were similar with both techniques, but pooled infective endocarditis was significantly more frequent in the TPVR group (5.8 vs 2.7%; pooled odds ratio, 3.09; 95% confidence interval, 1.89-5.06; P Conclusions TPVR is a safe alternative to SPVR in selected patients and is associated with a shorter length of hospital stay and fewer procedure-related complications. At midterm follow-up TPVR was comparable with SPVR in terms of mortality and repeat intervention but was associated with an increased risk of infective endocarditis.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Cardiac Catheterization
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Internal medicine
Pulmonary Valve Replacement
medicine
Clinical endpoint
Humans
Heart Valve Prosthesis Implantation
Pulmonary Valve
Endocarditis
business.industry
Odds ratio
Perioperative
Length of Stay
medicine.disease
Confidence interval
medicine.anatomical_structure
030228 respiratory system
Pulmonary valve
Infective endocarditis
Meta-analysis
Surgery
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15526259
- Volume :
- 110
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- The Annals of thoracic surgery
- Accession number :
- edsair.doi.dedup.....93e2a509a73a0e41fd8ea499e409757b