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January 1, 2021Sunhwan'giOpen Access

Pulmonary valve replacement was associated with a significantly higher 20-year overall survival rate (100% vs 88.7%) compared to no replacement in patients with repaired tetralogy of Fallot.

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Why the study?

The study was conducted to review long-term outcomes following tetralogy of Fallot repair with trans-annular incision and to evaluate the effectiveness of pulmonary valve replacement on those outcomes.

Does pulmonary valve replacement improve survival and reduce adverse events in patients with repaired tetralogy of Fallot with trans-annular incision?

Population

180 patients who underwent total correction for TOF with trans-annular incision

Comparison

PVR group vs non-PVR group

Design

Retrospective review

Follow-up

More than 20 years

Key result

Pulmonary valve replacement was associated with a significantly higher 20-year overall survival rate (100% vs 88.7%) compared to no replacement in patients with repaired tetralogy of Fallot.

Authors

JKJae Gun KwakHSHong Ju ShinJBJi Hyun Bang

Discussion

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Member takes

Overview

PVR after transannular TOF repair was associated with higher 20-year survival; leaves open whether routine PVR improves outcomes in modern practice.

Study Design

Type

Cohort (n=180)

Multicenter

No

Structured PICO

Does pulmonary valve replacement improve survival and reduce adverse events in patients with repaired tetralogy of Fallot with trans-annular incision?

P
Population
180 patients who underwent total correction of tetralogy of Fallot with trans-annular incision, followed for a median of 24.8 years to evaluate the effects of subsequent pulmonary valve replacement.
E
Exposure
Pulmonary valve replacement (PVR) during follow-up
C
Comparator
No pulmonary valve replacement (non-PVR)
O
Outcome
Overall survival rate and all adverse events (arrhythmia, neurologic complications) at 20 yearshard clinical

Main Result

Absolute Event Rate: 100% vs 88.7%

p-value: p=0.007

In patients with repaired tetralogy of Fallot with trans-annular incision, subsequent pulmonary valve replacement is associated with improved 20-year survival and reduced adverse events.

Limitations

  • Retrospective review from a single center.
  • Incomplete data sets and missing hospital records from the early study period.
  • Lack of matched analysis between PVR and non-PVR groups.
  • Some patients were not followed up regularly, with 11% not visiting the hospital for over 10 years.

Cite This Study

Kwak et al. (2021) conducted a cohort in Repaired Tetralogy of Fallot with trans-annular incision (n=180). Pulmonary valve replacement (PVR) vs. Non-pulmonary valve replacement (non-PVR) was evaluated on Overall survival rate at 20 years (p=0.007). Pulmonary valve replacement was associated with a significantly higher 20-year overall survival rate (100% vs 88.7%) compared to no replacement in patients with repaired tetralogy of Fallot.

synapsesocial.com/papers/6a9fc5c868f5edfbe744a6dfhttps://doi.org/10.4070/kcj.2020.0331
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Long-term outcomes of pulmonary valve replacement in patients with repaired tetralogy of Fallot2020 · 16 citations
  2. 2Pulmonary Valve Replacement in Tetralogy of Fallot2009 · 331 citations
  3. 3Early replacement of pulmonary valve after repair of tetralogy: is it really beneficial?☆2004 · 81 citations
  4. 4Pulmonary valve replacement in primary repair of tetralogy of Fallot in adult patients2020 · 5 citations
  5. 5Pulmonary valve replacement in patients with corrected tetralogy of Fallot2017 · 16 citations