Surgical pulmonary valve redo versus transcatheter pulmonary valve replacement for Tetralogy of Fallot patients.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-03-24 DOI:10.1080/14779072.2025.2482926

Michail Penteris, Konstantinos Lampropoulos

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引用次数: 0

Abstract

Objectives: To perform a systematic review to compare the efficacy and safety of transcatheter pulmonary valve replacement (TPVR) and surgical pulmonary valve replacement (SPVR) in managing pulmonary valve dysfunction in Tetralogy of Fallot (TOF) patients.

Methods: This review investigates through three different databases for randomized control trials or observational studies evaluating TOF patients who underwent TPVR or SPVR until November 2024. The outcomes of interest were hemodynamic improvement, reduction in pulmonary regurgitation or stenosis, complications, quality of life, and long-term outcomes.

Results: Four retrospective studies (1919 procedures) were analyzed. TPVR was non-inferior to SPVR, with a comparable safety profile. The durability of bioprosthetic valves was similar between TPVR and SPVR (HR: 0.97, 95% CI: 0.55-1.73; p = 0.93) and was influenced by patients' age at PVR (HR: 0.78 per 10 years from <1 year; 95% CI: 0.63-0.96; p = 0.02) and true inner valve diameter .

Conclusions: TPVR is a safe and less-invasive alternative to SPVR with comparable efficacy in reducing pulmonary regurgitation. Complication rates are similar and valve durability is primarily age- and valve size-dependent. Although further research on long term outcomes is needed, TPVR may be integrated into routine practices, offering a viable alternative for high-risk TOF patients.

Registration: This systematic review was registered on the international prospective register of systematic reviews (PROSPERO; #CRD42024615871).

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法洛氏四联症患者肺动脉瓣重修手术与经导管肺动脉瓣置换术的比较。

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来源期刊

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

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0.00%

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期刊介绍： Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.