OR13-6
Clinical Outcomes of Transcatheter Pulmonary Valve Replacement Versus Surgical Pulmonary Valve Replacement: A Meta-Analysis
Presenter
Dr. Hasaan Ahmed, MD, Creighton University School of Medicine, Omaha, NE
Dr. Hasaan Ahmed, MD1, Mahmoud Ismayl, M.D.2, Anirudh Palicherla, MD3, Ruth Ann Mathew Kalathil, MD1, Jacob Brenner, DO1, Jalal Dufani, MD1, Amjad Kabach, M.D.4, Dr. Andrew Michael Goldsweig, MD, MS, FSCAI5 and Ahmed Aboeata, MD1, (1)Creighton University School of Medicine, Omaha, NE, (2)Mayo Clinic College of Medicine and Science, Rochester, MN, (3)Creighton University , Omaha, NE, (4)CHI Health Creighton University Medical Center, Omaha, NE, (5)University of Massachusetts - Baystate Medical Center, West Hartford, CT
Keywords: Complications, TPVR/Pulmonary Valve and Vascular Access, Management, and Closure
Background
Transcatheter pulmonary valve replacement (TC-PVR) has become increasingly performed in patients with pulmonary regurgitation and/or stenosis, serving as a growing alternative to surgical pulmonary valve replacement (S-PVR). We aimed to evaluate clinical outcomes of TC-PVR versus S-PVR in patients undergoing pulmonary valve replacement. Methods
We searched several databases for studies comparing outcomes of
TC-PVR versus S-PVR in patients undergoing pulmonary valve replacement. We used a common-effect model to calculate risk ratios (RR) with 95% confidence intervals in R studio. Outcomes assessed were all-cause mortality, infective endocarditis, post-operative arrhythmias, and prolonged intubation.
Results
We identified a total of 6 studies consisting of 1295 patients of which 505 underwent TC-PVR and 790 underwent S-PVR. TC-PVR was associated with a significantly increased risk of infective endocarditis (RR 4.79; 95% CI 1.69 - 13.58) and a significantly decreased risk of post-operative arrhythmias (RR 0.23 95% CI 0.08 - 0.72) compared to S-PVR. All-cause mortality (RR 0.71; 95% CI 0.28 - 1.82) and prolonged intubation (RR 0.37; 95% CI 0.09 - 1.49) were similar between both TC-PVR and S-PVR.
Conclusions
Our meta-analysis found
TC-PVR was associated with an increased risk of infective endocarditis and a decreased risk of post-operative arrhythmias, compared to S-PVR, with similar outcomes of all-cause mortality and prolonged intubation noted between both groups. These findings should be considered in patients requiring pulmonary valve replacement. 