Transcatheter Pulmonary Valve Implantation: A Comprehensive Systematic Review and Meta-Analyses of Observational Studies.

Abstract:

BACKGROUND:Transcatheter pulmonary valve implantation is approved for the treatment of dysfunctional right ventricle to pulmonary artery conduits. However, the literature is limited because of a small patient population, and it does not reflect changing procedural practice patterns over the last decade. METHODS AND RESULTS:A comprehensive search of Medline and Scopus databases from inception through August 31, 2016 was conducted using predefined criteria. We included studies reporting transcatheter pulmonary valve implantation in at least 5 patients with a follow-up duration of 6 months or more. In 19 eligible studies, 1044 patients underwent transcatheter pulmonary valve implantation with a pooled follow-up of 2271 person-years. Procedural success rate was 96.2% (95% confidence intervals [CI], 94.6-97.4) with a conduit rupture rate of 4.1% (95% CI, 2.5-6.8) and coronary complication rate of 1.3% (95% CI, 0.7-2.3). Incidence of reintervention was 4.4 per 100 person-years overall (95% CI, 3.0-5.9) with a marked reduction in studies reporting ≥75% prestenting (2.9 per 100 person-years [95% CI, 1.5-4.3] versus 6.5/100 person-years [95% CI, 4.6-8.5]; P<0.01). Pooled endocarditis rate was 1.4 per 100 person-years (95% CI, 0.9-2.0). CONCLUSIONS:Our study provides favorable updated estimates of procedural and follow-up outcomes after transcatheter pulmonary valve implantation. Widespread adoption of prestenting has improved longer-term outcomes in these patients.

journal_name

J Am Heart Assoc

authors

Chatterjee A,Bajaj NS,McMahon WS,Cribbs MG,White JS,Mukherjee A,Law MA

doi

10.1161/JAHA.117.006432

subject

Has Abstract

pub_date

2017-08-04 00:00:00

issue

8

issn

2047-9980

pii

JAHA.117.006432

journal_volume

6

pub_type

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