Valve-sparing repair reduced mortality risk by 60% compared to transannular patch repair in patients undergoing tetralogy of Fallot correction (RR 0.40).
Meta-Analysis (n=11,723)
Yes
Does valve-sparing repair improve post-operative complications and cardiac function compared to transannular patch repair in patients with tetralogy of Fallot?
Valve-sparing repair is favored over transannular patch repair in Tetralogy of Fallot due to better preservation of pulmonary valve function, lower mortality, and reduced long-term right ventricular dysfunction.
Effect estimate: RR 0.40
The aim is to evaluate the transannular patch (TAP) repair and valve-sparing repair (VSR) techniques following tetralogy of Fallot (TOF) correction, focusing on post-operative complications and cardiac function. A comprehensive search was performed in PubMed, EMBASE, and Scopus using relevant terms like “Tetralogy of Fallot, right ventricular outflow tract (RVOT), VSR, pulmonary valve replacement, transannular-patch repair”. Results indicated that VSR is favored due to its shorter cardiopulmonary bypass duration, preservation of the pulmonary valve, less demanding surgical requirements, shorter post-operative hospital stays, lower mortality rates, survival of at least 30 years, reduced pulmonary regurgitation, decreased right ventricular dysfunction, and improved physical activity tolerance and neurodevelopment. While TAP alleviates RVOT obstruction (RVOTO), it is associated with long-term pulmonary regurgitation. Both TAP and VSR are effective in managing TOF, but VSR provides better valve function preservation and long-term outcomes.
Gaikwad et al. (Sun,) conducted a meta-analysis in Patients undergoing surgical repair of tetralogy of Fallot (n=11,723). Valve-sparing repair (VSR) vs. Transannular patch (TAP) repair was evaluated on Mortality risk post-surgical repair (RR 0.40). Valve-sparing repair reduced mortality risk by 60% compared to transannular patch repair in patients undergoing tetralogy of Fallot correction (RR 0.40).