OR13-6 | Clinical Outcomes of Transcatheter Pulmonary Valve Replacement Versus Surgical Pulmonary Valve Replacement: A Meta-Analysis

Transcatheter pulmonary valve replacement (TC-PVR) has become increasingly performed in patients with pulmonary regurgitation and/or stenosis, serving as a growing alternative to surgical pulmonary valve replacement (S-PVR). We aimed to evaluate clinical outcomes of TC-PVR versus S-PVR in patients undergoing pulmonary valve replacement. We searched several databases for studies comparing outcomes of TC-PVR versus S-PVR in patients undergoing pulmonary valve replacement. We used a common-effect model to calculate risk ratios (RR) with 95% confidence intervals in R studio. Outcomes assessed were all-cause mortality, infective endocarditis, post-operative arrhythmias, and prolonged intubation. We identified a total of 6 studies consisting of 1295 patients of which 505 underwent TC-PVR and 790 underwent S-PVR. TC-PVR was associated with a significantly increased risk of infective endocarditis (RR 4.79; 95% CI 1.69 - 13.58) and a significantly decreased risk of post-operative arrhythmias (RR 0.23 95% CI 0.08 - 0.72) compared to S-PVR. All-cause mortality (RR 0.71; 95% CI 0.28 - 1.82) and prolonged intubation (RR 0.37; 95% CI 0.09 - 1.49) were similar between both TC-PVR and S-PVR. Our meta-analysis found TC-PVR was associated with an increased risk of infective endocarditis and a decreased risk of post-operative arrhythmias, compared to S-PVR, with similar outcomes of all-cause mortality and prolonged intubation noted between both groups. These findings should be considered in patients requiring pulmonary valve replacement.