Transcatheter Pulmonary Valve Implantation: A Comprehensive Systematic Review and Meta‐Analyses of Observational Studies. Issue 8 (4th August 2017)

• Record Type: Journal Article
• Authors: Chatterjee, Arka; Bajaj, Navkaranbir S.; McMahon, William S.; Cribbs, Marc G.; White, Jeremy S.; Mukherjee, Amrita; Law, Mark A.
• Is Part Of: Journal of the American Heart Association. Volume 6:Issue 8(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-08-04
• Subjects: endocarditis -- Melody valve -- reintervention -- transcatheter pulmonary valve; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.117.006432
• Languages: English
• ISSNs: 2047-9980

Abstract

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.