Preoperative Predictors of Death and Sustained Ventricular Tachycardia After Pulmonary Valve Replacement in Patients With Repaired Tetralogy of Fallot Enrolled in the INDICATOR Cohort
Key result
Pre-PVR right ventricular ejection fraction <40% (HR 2.39), RV mass-to-volume ratio ≥0.45 g/mL (HR 4.08), and age ≥28 years (HR 3.10) predicted death or sustained ventricular tachycardia after PVR.
Why the study?
What are the preoperative predictors of death and sustained ventricular tachycardia after pulmonary valve replacement in patients with repaired tetralogy of Fallot?
Population
452 patients with repaired tetralogy of Fallot enrolled in the INDICATOR cohort who had a comprehensive…
Design
Cohort
Follow-up
median 6.5 years
Authors
Discussion
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Member takes
Implication
Supports risk stratification after PVR in repaired tetralogy of Fallot; hypothesis-generating for prospective validation and intervention trials.
Study Design
Type
Cohort (n=452)
Multicenter
Yes
Structured PICO
What are the preoperative predictors of death and sustained ventricular tachycardia after pulmonary valve replacement in patients with repaired tetralogy of Fallot?
P
Population
452 patients with repaired tetralogy of Fallot undergoing pulmonary valve replacement, followed for a median of 6.5 years.
E
Exposure
Preoperative clinical, ECG, and cardiovascular magnetic resonance evaluation prior to pulmonary valve replacement
O
Outcome
Composite of death, aborted sudden cardiac death, or sustained ventricular tachycardiacomposite
Main Result
Hazard Ratio: 2.39 (95% CI 1.18–4.85)
p-value: p=0.02
In patients with repaired tetralogy of Fallot, older age at PVR and pre-PVR right ventricular hypertrophy and dysfunction (RVEF <40%, RV mass-to-volume ratio ≥0.45 g/mL) predict shorter time to postoperative death and sustained ventricular tachycardia.
Limitations
- Observational design requiring confirmation by prospective clinical trials
- Observational investigation
Cite This Study
Geva et al. (2018) conducted a cohort in Repaired tetralogy of Fallot (n=452). Pre-PVR right ventricular ejection fraction <40% vs. Pre-PVR right ventricular ejection fraction ≥40% was evaluated on Death, aborted sudden cardiac death, or sustained ventricular tachycardia (HR 2.39, 95% CI 1.18-4.85, p=0.02). Pre-PVR right ventricular ejection fraction <40% (HR 2.39), RV mass-to-volume ratio ≥0.45 g/mL (HR 4.08), and age ≥28 years (HR 3.10) predicted death or sustained ventricular tachycardia after PVR.