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

IF 2.1 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。

目的：对经导管肺动脉瓣置换术（TPVR）和外科肺动脉瓣置换术（SPVR）治疗法洛四联症（TOF）患者肺动脉瓣功能障碍的疗效和安全性进行系统评价。方法：本综述通过三个不同的数据库，对2024年11月前接受TPVR或SPVR的TOF患者进行随机对照试验或观察性研究。关注的结果是血流动力学改善、肺返流或狭窄减少、并发症、生活质量和长期预后。结果：对4项回顾性研究（1919例）进行分析。TPVR不逊于SPVR，具有相当的安全性。TPVR和SPVR的生物假体瓣膜耐久性相似(HR: 0.97, 95% CI: 0.55-1.73；p = 0.93)，并受患者在PVR时的年龄（HR: 0.78 / 10年，p = 0.02）和真内瓣直径的影响。结论：与SPVR相比，TPVR是一种安全、微创的替代方法，在减少肺反流方面具有相当的疗效。并发症发生率相似，阀门耐久性主要取决于年龄和阀门尺寸。虽然需要对长期结果进行进一步的研究，但TPVR可能会纳入常规实践，为高风险TOF患者提供可行的替代方案。注册：该系统评价已在国际前瞻性系统评价注册(PROSPERO；# CRD42024615871)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

0.00%

发文量

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.