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Updated: Aug 23, 2025
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Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
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Infective endocarditis after transcatheter approach versus surgical pulmonary valve replacement: A meta-analysis
Elif Ijlal Çekirdekçi1, Barış Bugan2, Lütfi Çağatay Onar3
1Department of Cardiology, University of Kyrenia, Kyrenia, Turkish Republic of Northern Cyprus.
Turk Gogus Kalp Damar Cerrahisi Dergisi
|October 28, 2022
Summary
Transcatheter pulmonary valve replacement shows a higher risk of infective endocarditis compared to surgical replacement. Surgical intervention remains a viable option for patients at high risk, preventing 30 cases per 1,000 patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Devices
Background:
- Pulmonary valve replacement is crucial for managing severe right ventricular outflow tract dysfunction.
- Transcatheter pulmonary valve replacement (TPVR) offers a less invasive alternative to surgical pulmonary valve replacement (SPVR).
- The risk of infective endocarditis (IE) following TPVR versus SPVR requires thorough investigation.
Purpose of the Study:
- To compare the incidence of infective endocarditis (IE) between patients undergoing transcatheter pulmonary valve replacement (TPVR) and surgical pulmonary valve replacement (SPVR).
- To quantify the risk difference in IE between TPVR and SPVR.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Cochrane, EMBASE, Scopus, Web of Science).
- Studies published between December 2012 and December 2021 reporting IE events in both TPVR and SPVR were included.
- A random-effects meta-analysis model was employed to synthesize the data from 15 comparison groups (4,706 patients).
Main Results:
- Patients undergoing TPVR exhibited a significantly higher risk of infective endocarditis (IE) compared to those receiving SPVR (OR 2.68, 95% CI: 1.83-3.93, p<0.00001).
- The absolute risk difference indicated that 30 cases of IE could be prevented per 1,000 patients treated with SPVR instead of TPVR.
- Meta-regression analysis did not reveal a statistically significant association between follow-up duration and IE incidence (p=0.753).
Conclusions:
- Despite its feasibility, TPVR is associated with an elevated risk of IE, posing a significant clinical concern.
- Surgical pulmonary valve replacement remains a critical and viable therapeutic option, particularly for patients with prohibitive risks for transcatheter procedures.
- These findings underscore the importance of considering IE risk when selecting the optimal pulmonary valve replacement strategy.
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