Transcatheter pulmonary valve implantation: A comprehensive systematic review and meta-analyses of observational studies

Academic Article

Abstract

  • © 2017 The Authors and Medtronic. 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.
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    Author List

  • Chatterjee A; Bajaj NS; McMahon WS; Cribbs MG; White JS; Mukherjee A; Law MA
  • Volume

  • 6
  • Issue

  • 8