Why the study?
The study was conducted to assess the risk of infective endocarditis in transcatheter versus surgical pulmonary valve replacement patients.
Does transcatheter pulmonary valve replacement increase the risk of infective endocarditis compared to surgical pulmonary valve replacement?
Does transcatheter pulmonary valve replacement increase the risk of infective endocarditis compared to surgical pulmonary valve replacement?
Transcatheter pulmonary valve replacement is associated with a significantly higher risk of infective endocarditis compared to surgical replacement, with an absolute risk difference of 3%.
Favors surgical over transcatheter pulmonary valve replacement to reduce infective endocarditis risk when feasible; confirms elevated risk in aggregated evidence.
Background: In this meta-analysis, we aimed to assess the risk of infective endocarditis in transcatheter versus surgical pulmonary valve replacement patients. Methods: We systematically searched PubMed, Cochrane, EMBASE, Scopus, and Web of Science for the studies that reported the event rate of infective endocarditis in both transcatheter and surgical pulmonary valve replacement between December 2012 and December 2021. Random-effects model was used in the meta-analysis. Results: Fifteen comparison groups with 4,706 patients were included. The mean follow-up was 38.5±3.7 months. Patients with transcatheter pulmonary valve replacement had a higher risk of infective endocarditis than patients receiving surgically replaced valves (OR 2.68, 95% CI: 1.83-3.93, p<0.00001). The calculated absolute risk difference was 0.03 (95% CI: 0.01-0.05), indicating that if 1,000 patients received a surgical valve replacement, 30 cases of infective endocarditis would be prevented. A meta-regression of follow-up time on the incidence of infective endocarditis was not statistically significant (p=0.753). Conclusion: Although transcatheter pulmonary valve replacement is a feasible alternative to surgical replacement in severe right ventricular outflow tract dysfunction, the higher incidence of infective endocarditis in transcatheter replacement remains a significant concern. Regarding this analysis, surgical treatment of right ventricular outflow tract dysfunction is still a viable option in patients with prohibitive risk.
No takes yet. Share an insight, caveat, or question.
Çekirdekçi et al. (2022) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: